Diagnostic Challenge in a Sickle Cell Disease Patient with COVID-19

Rodrigues, J; Silva, TM; Garcia, AM; Soares, E; Brito, MJ

http://hdl.handle.net/10400.17/4280

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Abstract(s)

Acute chest syndrome is a life-threatening complication in sickle cell disease. Infections are frequently implied, and like other viruses, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may be a trigger. In addition, due to their inflammatory status, they may present a higher risk for severe coronavirus disease 2019 (COVID-19). Pneumonia and acute chest syndrome share clinical, laboratory, and radiological features and may overlap, which makes their differential diagnosis especially challenging. We describe a case of an adolescent with homozygous sickle cell disease that developed acute chest syndrome in the context of COVID-19. With it, we intend to bring awareness to the potential role of imaging in the differential diagnosis and in establishing the best approach for the patient. Chest computed tomography findings were suggestive of an alternative diagnosis to COVID-19 pneumonia and red cell transfusion, fluid management, analgesics, and antibiotics were administered with favorable outcome.

Keywords

Acute Chest Syndrome/diagnosis Acute Chest Syndrome/diagnostic imaging Acute Chest Syndrome/therapy Anemia, Sickle Cell/ complications COVID-19/complications Diagnosis, Differential SARS-CoV-2 Tomography, X-ray Computed Adolescent HDE IMA HDE INF PED