thalassemia minor and covid immunity

A second dose of Pfizer or Moderna at least 4 weeks after 1st dose, less susceptibility to developing COVID-19, fewer intensive care unit (ICU) admissions, higher susceptibility to dying from COVID-19, surgery to remove your spleen or gallbladder. Noun P, Ibrahim A, Hodroj MH, Bou-Fakhredin R, Taher AT. Clin Lab Med. Beta-Thalassemia minor and SARS-CoV-2, prevalence, severity, morbidity 5, 25, 26, 27 However, no details were provided as to the outcomes and course of the pregnancy in this . What to Know About Thalassemia and COVID-19. Some studies estimate the worldwide prevalence of alpha-thalassemia trait to be as high as 5%. On the other, people with thalassemia may be at risk of adrenal insufficiency (adrenal crisis), which can worsen a person's condition with severe COVID-19. Alpha thalassemia. COVID-19 and thalassemia: Frequently asked questions. There have been multiple studies on blood types and COVID-19 risk. They do not require any specific treatment. However, more epidemiological studies are required in the aim to obtain a strong signal. If you become infected, it's important to talk to a doctor knowledgeable about thalassemia regarding any special precautions you should take or changes to your medical plan. Thalassemia: Complications and Treatment | CDC You inherit two copies of this gene one from each parent. 2020;95(8):E208-E210. At this point in time, there does not appear to be any relationship between blood type and COVID-19related severity of illness or mortality.". A recent study in the Lombardy region identified the positivity of anti-Covid-19 antibodies in 4.5 . The information in this article is current as of the date listed. If the inherited mutation affects only one gene, you have beta-thalassemia minor. Clinical guidance on COVID-19 vaccines for people with thalassemia. If the synthesis from both genes is severely reduced or absent, the person has . Treatment is with corticosteroids. Bethesda, MD 20894, Web Policies "We all recognize that we're not the same, but we have not been able, on a genetic basis, very often, to determine whether certain people with certain genes are more or less susceptible to get an infection if they're exposed to a germ," said William Schaffner, MD, an infectious disease specialist, and professor at the Vanderbilt University School of Medicine. Kakkar S, et al. This is the most severe form of this disorder. Jean-Mignard E, et al. Thalassemias. However, the results have been inconsistent and so the connection between COVID-19 and different blood types still isn't clear. In Italy there are about 5000 patients with dependent transfusion thalassemia (source Italian Thalassemia and Hemoglobinopathies - SITE) and a smaller number, currently not definable, of patients with sickle cell anemia in chronic transfusion. Am J Hematol. 2020 Sep 25;15(1):265. doi: 10.1186/s13023-020-01543-0. That said, the shortage of the blood supply has proven challenging. Objectives: Many patients with haemoglobinopathies, including thalassaemia and sickle cell disease, are at increased risk of developing severe complications from the coronavirus disease 2019 (COVID-19). Thalassemia is classified as alpha or beta depending on the part of hemoglobin your body isnt producing in adequate amounts. Daidone R, Carollo A, Perricone MP, Messina R, Balistreri CR. De Sanctis V, Canatan D, Corrons JLV, et al. If your MCV is too low, they may order further blood tests to check for thalassemia trait. As new research becomes available, well update this article. If symptoms occur, theyre likely to be mild. In fact, fewer than 57% of all Americans know their blood type, according to a 2019 survey from Quest Diagnostics. You can find out more about our use, change your default settings, and withdraw your consent at any time with effect for the future by visiting Cookies Settings, which can also be found in the footer of the site. If the mutation affects three of your genes, you have a more severe case of alpha-thalassemia. Epub 2020 Apr 27. Its important for a doctor to order a blood test to confirm the cause of your symptoms to ensure you dont receive any unnecessary treatment. Learn more about COVID-19 vaccination for people with beta-thalassemia or . This causes less severe anemia. But because reinfection is possible and COVID-19 can cause severe medical complications, it's recommended that people who . You can learn more about how we ensure our content is accurate and current by reading our. 10.1111/ejh.13410 Beta thalassemia may protect against COVID 19. Guidelines for the Management of NonTransfusion Dependent Thalassaemias, 2nd ed. Some research findings have suggested that people with blood types A and AB are more susceptible to contracting COVID-19, while those with blood type O are less likely to test positive for the virus. HHS Vulnerability Disclosure, Help doi:10.12659/MSMBR.929207, Drouin E. Beta-thalassemia may protect against COVID 19. Its most common in Southeast Asia, the Middle East, and the Mediterranean. Expert Rev Hematol. It causes mild to severe respiratory illness with some flu-like symptoms. Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. (2022). Vulnerability of -thalassemia heterozygotes to COVID-19: Results from a cohort study. The result will depend on the number of affected genes. They also may have antiviral effects and positive effects on the immune system, particularly with RNA viruses (viruses that have RNA as its genetic material, such as the virus causing COVID-19). That means getting vaccinated and boosted, social distancing, wearing a mask in public, and washing your hands regularly, among other things. Thalassemia is an inherited disorder that impairs the production of hemoglobin. You can learn more about how we ensure our content is accurate and current by reading our. People with beta thalassemia minor might never know they have the disease. Some of these release special . Home isolation in transfusion-dependent thalassemia patients with SARS CoV2 infection: Experience from a developing country. Iron overload: Frequent transfusions due to thalassemia can cause a build up of iron in the blood, which can, in turn, lead to heart disease, liver disease, diabetes, adrenal insufficiency, and other issues.These conditions are linked to poorer COVID-19 outcomes. However, severe allergic reactions from vaccines are extremely rare. Before Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Gholinataj Jelodar M, Mirzaei S, Dehghan Chenari H. Clin Case Rep. 2022 Aug 3;10(8):e6114. World Health Organization (WHO) . Eur J Haematol. Bender MA, et al. Needs T, et al. At the current time, there is no evidence that the SARS-CoV-2 virus can be transmitted by blood transfusion, and if present at all, the risk is likely to be very low. There are three types of thalassemia, one is minor and the other two Alpha and Beta thalassemia are a major threat to health of a person. 2020 Jun;25(6):e936-e945. There are a number of factors that might increase the chances of a person with thalassemia being exposed to SARS-CoV-2, the virus causing COVID-19. Yet, no matter how difficult the trial, there are often positive points. The results provide hope that people receiving SARS-CoV-2 vaccines will develop similar lasting immune memories after vaccination. This complication should be monitored and treated as it is for people with other forms of preexisting heart disease. The results align with the results of other studies from countries around the world. What are the symptoms of beta thalassemia? (2022). Treatment may include regular blood transfusions. Some of the publications discussing pregnancy in a patient with COVID19 infection mentioned thalassemia, thalassemia trait, and thalassemia minor in the list of comorbidities in the description of their included patients characteristics. Blood transfusions are a mainstay of treatment for some people with thalassemia. In some cases, the inherited mutation can cause the HBB gene to be absent. Its severity varies greatly between people. PMC Beta thalassemia minor or thalassemia trait. A protein called the Rh factor can also be present (+) or absent (-) from the blood. This means red blood cells aren't made properly or they are destroyed. Iron . 2020;60(12):3046-3054.doi:10.1111/trf.16056, d'argon A, Putri MG, Savitri Y, Alfaidin AMR. "Long COVID" is a term meaning symptoms that persist after the infection has cleared. Common COVID-19 treatments, including prone positioning (turning a patient on their stomach), non-invasive ventilation (oxygen delivered via a face mask), and intubation and mechanical ventilation (where a tube is inserted down the throat and a machine pumps air in and out of the lungs), may be needed depending on the severity. The third group includes people with Thalassemia minor, who have mild anaemia only. Richard N. Fogoros, MD, is a retired professor of medicine and board-certified internal medicine physician and cardiologist. 2020; 10.1002/ajh.25840 [Epub ahead of print]. doi:10.23750/abm.v91i3.10155, De Sanctis VD, Canatan D, Corrons JLV, et al. This site needs JavaScript to work properly. Other types of thalassemia cause more severe symptoms that can be found earlier in life, usually before a child is . Farmakis D, Giakoumis A, Angastiniotis M, Eleftheriou A. In this study, the most common side effects in people with thalassemia were: Researchers are still examining how COVID-19 affects people with beta thalassemia. When looking into thalassemia and COVID-19 risk, it's important to identify both the risk of potential exposure and susceptibility. While there are no specific guidelines at this time, some researchers believe that hemoglobin levels should be monitored closely in people with thalassemia if they develop COVID-19, even when symptoms are only mild. The current evidence suggests that the benefits of COVID-19 vaccination outweigh the risk of side effects for most people with autoimmune disease, according to the Global Autoimmune Institute, which reviewed the available scientific literature. It can cause life threatening heart conditions, such as stroke. 2019;133(12):1279-1289.doi:10.1182/blood-2018-10-879247, Yasara N, Premawardhena A, Mettananda S. A comprehensive review of hydroxyurea for -haemoglobinopathies: the role revisited during COVID-19 pandemic. While blood transfusions and iron chelation therapy (iron-binding drugs that are sometimes given via infusion) require traveling to a clinic or hospital, there are many healthcare visits that can be handled virtually. Disclaimer. Thalassemias | Johns Hopkins Medicine The pandemic has been hard on everyone, especially those with chronic illnesses. Although epidemiologic evidence concerning the novel coronavirus (SARS-CoV-2) infection in these patients is currently lacking, the COVID-19 pandemic represents a significant challenge for . We avoid using tertiary references. 2020;7:306.doi:10.3389/fmed.2020.00306, Mungmunpuntipantip R, Wiwanitkit V. Hemoglobinopathy and COVID-19, Hematol Transfus Cell Ther. SARS-CoV-2 infection in patients with -thalassemia: The French FOIA 2020;15(1):265.doi:10.1186/s13023-020-01543-0, Piga A, Perrotta S, Gamberini MR, et al. 2020;105(1):1623. Autosomal means the affected genes arent on sex chromosomes. COVID-19; SARS-CoV-2; coronavirus; haemoglobinopathies; pandemic; thalassaemia. Published by John Wiley & Sons Ltd. Strategies to enhance information sharing, Strategies to enhance information sharing between healthcare professionals and patients and their families, Patient pathways during the pandemic: general pathway (left panel) and transfusiondependent patient pathway, A proposed algorithm for the diagnosis of COVID19 in patients with haemoglobinopathies [Colour, MeSH As a result, our understanding of the connection to blood type continues to evolve. COVID Increases Risk of Long-Term Brain Injury, Study Shows, COVID Tongue: How a Swollen Tongue Could Indicate COVID-19, Even Mild COVID-19 Infections Increase Risk of Type 2 Diabetes, Research Shows, CDC Adds Mental Health Conditions to High-risk of Severe Illness From COVID List, COVID-19 Pneumoniathe Lung Infection Caused by Getting COVID-19, Does Sunlight Kill COVID-19 and Does Vitamin D Prevent It? If you have a family history of thalassemia, you may want to know whether you carry the trait. Thalassaemia International Federation . The Link Between Blood Type and COVID-19 Risk - Health (2021). "At the end of the day, we're still not sure if blood type makes a difference," said Dr. Russo. FDA Approves First Cell-Based Gene Therapy to Treat Adult and Pediatric Patients with Beta-thalassemia Who Require Regular Blood Transfusions. S124: Adverse events following COVID-19 vaccination in transfusion-dependent thalassemia patients. Biochemistry, hemoglobin synthesis. April 21, 2020. In a 2021 pilot study, researchers found a strong association between the presence of beta thalassemia minor and COVID-19 mortality. For people living with thalassemia, because too much iron may build up in the blood, foods high in iron may need to be limited. (2020). Blood tests can also be used for . If both parents carry a trait for either alpha- or beta-thalassemia, their child could develop a severe form of the disease. A doctor can look at your mean corpuscular volume (MCV) reading on your CBC results to determine the size of your red blood cells. Beta-Thalassemia Minor and SARS-CoV-2: Physiopathology, Prevalence, Severity, Morbidity, and Mortality. Looking at a small sample group early on in the pandemic, the overall mortality rate of those with thalassemia from a COVID-19 infection was 18.6%, compared with a mortality rate of 4.71% in the general population. For the latest on COVID-19, visit our coronavirus news page. But such tests are often costly. Experts are warning people that they may have an allergy to red meat if they develop these gastrointestinal symptoms. Risk of transmission of severe acute respiratory syndrome coronavirus 2 by transfusion: A literature review. But you can pass the gene on to future generations. A few options include: Current recommendations are that for people who have been treated with Reblozyl, the medication should be continued even if a person develops COVID-19 (there is no evidence that it should be stopped). 2020;143:110014.doi:10.1016/j.mehy.2020.110014, Motta I, De Amicis MM, Pinto VM, et al. Hemoglobin is the iron-containing part of your red blood cells that allows them to carry oxygen throughout your body. (2022). In a webinar designed to guide physicians in the care of hematology patients during the COVID-19 pandemic, three world experts on thalassemia and sickle cell disease (SCD) provided on-the-ground information from physicians who were . Certain medications have been approved to reduce the frequency of transfusions needed. Thats because two genes, HBA1 and HBA2, are responsible for making hemoglobin alpha. Unauthorized use of these marks is strictly prohibited. People with thalassemia should assume that they are as likely to become infected as the general population and are more likely to have severe outcomes. In order of increasing severity, its classified as: People with beta thalassemia minor usually dont develop symptoms and have mild anemia. People with thalassemia tend to experience similar complications from COVID-19 as those without thalassemia. Thalassemia - Diagnosis and treatment - Mayo Clinic "We still do not understand all the factors at play," said Anupama Nehra, MD, an assistant professor at the Rutgers New Jersey Medical School and clinical director of hematology-oncology at Rutgers Cancer Institute at University Hospital. There has also been a shortage at other steps in the process, such as personnel available to perform collections, as well as process and deliver donated blood. Healthline Media does not provide medical advice, diagnosis, or treatment. According to this systematic-review meta-analysis, beta-thalassemia carriers could be less affected by CO VID-19 than the general population and more susceptible to die from COVID-19 or one of its consequences. Its also the only way to tell if youre a silent carrier. Summary document for interim clinical considerations for use of COVID-19 vaccines currently authorized or approved in the United States. Can SARS-CoV-2 be transmitted via blood transfusions? Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. If you have concerns, speak with a doctor or healthcare professional about your individual risks. The https:// ensures that you are connecting to the Thalassemia is a genetic blood disorder caused by an inherited mutation in your HBB gene. Am J Hematol. In thalassemia, the body is unable to make either alpha or beta chains in adequate amounts. When there isn't enough hemoglobin, the body's red blood cells don't function properly and they last shorter periods of time, so there are fewer healthy red blood cells traveling . Thalassemia Benefits. However, some limited evidence suggests that certain types of thalassemia may have some protective effect against COVID-19. Vaccination can help prevent COVID-19 infection and prevent severe illness if you do. Immunity is your body's ability to protect you from getting sick when you are exposed to an infectious agent ("germ") such as a bacterium, virus, parasite or fungus. sharing sensitive information, make sure youre on a federal Med Sci Monit Basic Res. A person with beta thalassemia minor . Luspatercept improves hemoglobin levels and blood transfusion requirements in a study of patients with -thalassemia. Munkongdee T, et al. Lack of hemoglobin can lead to insufficient oxygen in your bodily tissues. With more research, we may one day have a clearer understanding of the connection between COVID-19 and different blood types. Within each of these types, the severity varies, from causing moderate to severe anemia to requiring frequent blood transfusions. doi: 10.1002/ccr3.6114. If you do, theyll be mild. Mark S. Lesney. A large repertoire of IgA is produced by B lymphocytes with T-independent and T-dependent mechanisms useful in defense against pathogenic microorganisms and to reduce immune activation. Nicosia, Cyprus: Thalassaemia International Federation; 2017. Care of patients with hemoglobin disorders during the COVID-19 pandemic: An overview of recommendations. This can make them very anaemic (tired, short of breath and pale). Laboratory diagnosis of thalassemia. Prevalence and severity of coronavirus disease 2019 (COVID-19) in transfusion dependent and non-transfusion dependent -thalassemia patients and effects of associated comorbidities: an Iranian nationwide study. Only one gene is damaged. If you're living with thalassemia, you may be at greater risk for serious outcomes of COVID-19. In spite of those terrible limits, this systematic-review meta-analysis opens the way to the confirmation of a possible protection/immunity of beta-thalassemia carriers against COVID-19 concerning incidence and ICU admission markers [7,8]. 24. Thalassemia: Types, Traits, Symptoms & Treatment - Cleveland Clinic While the link between blood type and COVID-19 risk is still unclear, it's important to note that there have been links between blood type and diseases in the past. Vitamin and mineral supplementation may be recommended for some people with thalassemia during the COVID-19 pandemic. Splenectomy: When a person has a spleen removed for thalassemia, they are more likely to develop a secondary bacterial infection . Some of these include: Secondary infections (bacterial infections that develop in people with a viral infection such as COVID-19) may be more common in people with thalassemia, especially those who have had their spleen removed. Most hemoglobin is made up of alpha and beta chains. But some researchers believe it may, based on the primarily mild symptoms of COVID-19 in people with thalassemia found in a study out of Southeast Asia. Verywell Health's content is for informational and educational purposes only. In a 2022 study, researchers found that people with beta thalassemia minor had a higher chance of dying from COVID-19 than people in the general population. Like in alpha-thalassemia minor, your red blood cells will be smaller, and you may experience mild anemia. "As an individual, you have your blood typethere's nothing you can do about it.". The need for frequent blood transfusions and complications of the disease that result in more clinic visits and hospitalizations could raise the odds that someone would come into contact with the virus. Torti L, Sorrentino F, Maffei L, De Fabritiis P, Abruzzese E. Mediterr J Hematol Infect Dis. (2022). Severe thalassemia used to be fatal by early adulthood, but now people frequently live into their 60s or beyond. chenevex, France. Working with your healthcare team to keep up with thalassemia treatments, getting vaccinated, and monitoring and treating for complications early if COVID-19 symptoms do develop are the recommended strategies to staying healthy through the pandemic. The Johnson & Johnsons Janssen can rarely cause arterial thrombosis, a blood clot in an artery, in people with thrombocytopenia 4 to 30 days after vaccination. Your red blood cells are likely to be smaller than is typical. If you have one unaffected gene, it mostly overrides the faulty gene. Beta thalassemia. A temporary drop in hemoglobin levels was noted 3 months after vaccination. Blood. Sotiriou S, et al. Still, you can pass on the disease to your child. Vaccines & immunizations: Use of COVID-19 vaccines in the U.S. (2022). They may not live a normal lifespan. The COVID-19 pandemic is putting a lot of burden on healthcare . "There is no real benefit for the individual person," said Torben Barington, DMSc, a clinical professor of immunology at the University of Southern Denmark and co-author of the early Danish study. Clipboard, Search History, and several other advanced features are temporarily unavailable. Thalassemia is a medical condition in which the body makes less hemoglobin than usual. Learn more about COVID-19 vaccination for people with beta-thalassemia or beta-thalassemia trait. They result in low hemoglobin production and destruction of red blood cells. Consider talking with a doctor about testing for thalassemia trait if theres a history of thalassemia or thalassemia trait in your family, or if you plan to have a child with someone who has the trait or a family history of it. According to research from 2020 and 2021, 93% of U.S. newborn screening programs provide some info on alpha-thalassemia and 85% provide info on beta-thalassemia. If you only receive the gene from one parent, you carry the trait for thalassemia. eCollection 2022. Coronavirus: People with thalassemia face "blood shortage", appeal for Regular screenings are often recommended. Thalassemias are inherited disorders characterized by abnormal production of hemoglobin, a protein in red blood cells that carries oxygen. Federal government websites often end in .gov or .mil. "All may acquire COVID-19 and all should take the recommended precautions to reduce the risk.". They only have one mutated HBB gene from their parents. Med (Lausanne). These findings may be due to statistical randomness because of the small sample size. Covid-19: Do many people have pre-existing immunity? | The BMJ The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Indian Pediatr. Beta-thalassemia may protect against COVID 19 - Semantic Scholar There are two damaged genes. doi:10.1002/ajh.25840, Farmakis D, Giakoumis A, Cannon L, et al. It could be that antigens for people with type O blood block the spike protein in SARS-CoV-2, and keeps it from entering into your cells, said Dr. Russo. The people with hidden immunity against Covid-19 - BBC Future The clues have been mounting . With thalassemia trait, your red blood cells are smaller than those in people who dont have the trait. Folic acid can help red blood cells develop. These drugs can reduce inflammation in blood vessels (endothelial inflammation) during viral infections. These medications bind to iron so that it can be expelled from the body. Thalassemia: Complications & treatment. Researchers found no link between blood type and COVID-19 risk, adding that more research was needed on the topic. Research suggests that people with thalassemia may be at a slightly increased risk of contracting COVID-19, especially those who are transfusion dependent which puts them at an increased risk of exposure to the virus. Beta-Thalassemia Minor and SARS-CoV-2: Physiopathology, Prevalence, Severity, Morbidity, and Mortality. Some people have been re-infected multiple times with the virus, while others appear to have avoided the virus entirely. People with beta thalassemia may be at a higher risk of developing severe disease or death, but studies are . How Might Swollen Glands Be a Sign of COVID-19? It's important to note that complications of thalassemia likely played a role in the severity of outcomes. Metabolism. Brancaleoni V, et al. Centers for Disease Control and Prevention (CDC), Vaccine safety and effectiveness for people with beta thalassemia. Mark S. Lesney. Researchers found inconsistent findings but did identify certain trends suggesting that blood type A might predispose one to increased susceptibility to infection with SARS-CoV-2 (the virus that causes COVID-19), or that type O and Rh-negative blood groups might be protective. What Are the Differences Between the Pfizer and Moderna COVID-19 Vaccines? Adrenal insufficiency (a lack of sufficient hormone production by the adrenal glands) can occur with thalassemia. Treatment can consist of blood transfusions and iron chelation therapy. And while some people develop more severe forms of COVID-19, others develop mild or no symptoms. Dr. DelCollo is board-certified in family medicine by the American Board of Family Medicine. Pregnancy outcomes among women affected with thalassemia traits. In order to better describe the frequency and manifestations of COVID-19 in thalassemia patients living in France, we report the cases of SARS-CoV-2 infection that occurred during the year 2020. Early in the pandemic, two studies published in the Blood Advances journal in October 2020 showed a possible link between blood type and vulnerability to COVID-19. Many times people with thalassemia are prescribed a supplemental B vitamin, known as folic acid, to help treat anemia. Thalassemia and Coronavirus (COVID-19): Complications - Verywell Health -, Motta I, Migone De Amicis M, Pinto VM, et al. Should people with thalassemia receive the COVID-19 vaccine? Information for people with thalassemia - COVID-19 Vaccine It's currently recommended that people with thalassemia who have severe COVID-19 be given blood thinners, though this could change as more is learned. Autoimmune diseases like Sjgrens syndrome can be difficult to diagnose. 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