Morbidity and mortality patterns in patients with thalassaemia during the COVID-19 pandemic in Sri Lanka;A single centre experience

Abstract

Introduction: Patients with thalassaemia syndromes (TS) affected with COVID-19 attending a thalassaemia centre in Sri Lanka situated in the region most affected with COVID-19 were studied over a 16-month period. Methods: To assess the collateral effects on overall thalassaemia care in the centre, data on transfusion, chelation and clinic attendance were analysed. Morbidity events and deaths recorded during the COVID-19 period and during a similar period before the beginning of COVID-19 infection in Sri Lanka were recorded in all clinic registrants. Results: Seven patients (of 502) with TS had developed COVID-19 during the 16-month period; all were minimally symptomatic and had recovered without complications. Number of monthly clinic visits reduced from 338 pre-COVID to 268 during COVID (p=0.004). Iron chelator usage too reduced during the pandemic period (p<0.001). Though admissions related to morbidity reduced during the pandemic (58 vs 16, p<0.001) there were more non-COVID deaths (8 vs 4). Conclusions: Numbers affected with COVID-19 were low and severity of infection was mild in this cohort of patients with TS. Collateral effect on the management of the unit and effects on mortality in this vulnerable population appears to have been substantial.