Is Sickle Cell Disease a Genetic Defense Against COVID-19?

Dr. Pavlos Msaouel answers questions from the Sickle Cell community. Sickle cell disease and trait evolved as a defense against Malaria, so what does this mean for the relationship between COVID-19 and the reported effectiveness of malaria treatment drugs like hydroxychloroquine (Plaquenil)? Dr. Msaouel points out that there is no evidence at this time to suggest Sickle Cell patients are at any less risk, and in fact they may be more vulnerable. Dr. Msaouel stresses the importance of self-monitoring, and to notify your physician if any breathing-related symptoms develop.

Dr. Pavlos Msaouel, Malaria, SCD communities, Sickle Cell Disease, sickle cell trait, COVID-19, resistance to COVID-19, hydroxychloroquine, plaquenil, chloroquine, genetic resistance, coronavirus, malaria treatment, University of Texas MD Anderson Cancer Center

About this expert

Pavlos Msaouel, MD, PhD

University of Texas, MD Anderson Cancer Center

Department of Genitourinary Medical Oncology, Division of Cancer Medicine

Transcript

Rebecca: Hi, this is Rebecca Law for Diverse  Health Hub and today we have Dr. Pavlos Msaouel joining us. He is a  kidney cancer expert with the University of Texas MD Anderson Cancer  Center. Dr. Msaouel, thank you so much for joining us.


Dr. Msaouel: Thank you for having me.


Rebecca: So many patients and families are touched by COVID-19 and we do  recognize that some communities are more vulnerable than others. Let’s  play fact or fiction for a moment. Are patients with sickle cell more or  less affected by COVID-19 as a result of their genetic predisposition?


Dr. Msaouel:
That  is a great question and actually that is something that I've been asked  by the community of individuals with sickle cell trait or disease  because many in those communities know that the reason why the sickle  cell trait or the disease evolved where in -- as a defense mechanism  against Malaria. And the reason the news and it has been researched in  the scientific community that drugs against malaria may have some  efficiency against COVID-19. This has not yet been fully proven, it's  being investigated but there is this notion and so the question that  people from the sickle cell trait and sickle cell disease communities  are asking is, "Well since the trait was evolved as a defense against  Malaria, does that make a difference with regards to how susceptible I  am to COVID-19?" And the answer is as far as we know, no it is not. For  somebody that has sickle cell trait more likely than not, this does not  make any difference. It is not the trait itself that affects how  susceptible, how vulnerable you are to COVID-19, it is other factors  that we all might have. So for example, if you have a history of very  bad lung disease, if you use to smoke a lot, or if you are smoking now a  lot, or if you have very bad diabetes or if you have advanced cancer,  those can affect how vulnerable somebody is to COVID-19 and it is not the sickle cell trait.

Now along these lines, the sickle cell disease which actually can cause a lot of symptoms during a patient's  lifetime, this may in theory make individuals more vulnerable to  COVID-19. So whereas the sickle cell trait which usually does not  produce any symptoms at all, does not affect how vulnerable somebody is  to COVID-19, the sickle cell disease might and it might make somebody more vulnerable to COVID-19. So, that gives an extra reason for  individuals who have the sickle cell disease to want to make sure that  they practice social distancing, they wash their hands regularly and  they follow the guidelines that the CDC updates us with.

Rebecca: What’s the bottom-line for vulnerable patients at this time?

Dr. Msaouel
So,  that is also a great question. Regarding the bottom line of what should  we do? I have let's say sickle cell trait or I have sickle cell  disease, how does COVID-19 affect me? So, I would say that you would be  as vulnerable as anybody else if you have the sickle cell trait and if  you have the sickle cell disease you may actually be more vulnerable to  the complications potentially of COVID-19. Now this has not been proven  conclusively and that makes sense because it's only been less than six  months since for all we know that this virus first came to humans, so  we're still learning about it but I feel that it is much more prudent  that we exercise caution. So, individuals who have sickle cell disease  can have a lot of complications for example, they can have damage in  their lungs and that may make them particularly vulnerable to COVID-19.  So, the bottom line is that we -- the people with sickle cell trait and  disease need to be careful especially individuals with sickle cell  disease need to be extra careful if possible to make sure that they do  not get infected by this virus and if they do in some cases it's  inevitable, no matter what we do we might get infected by this virus --  that they let their physician know. And if they start having any  concerning symptoms like for example, if they start having new  difficulty breathing or if the cough from the virus becomes too severe  they should notify their physician because that might be something that  needs to be very closely monitored to prevent further complications.


Rebecca: Dr. Msaouel, thank you so much for your dedication to patients and their families especially during this time.


Dr. Msaouel: Thank you for doing this, I hope it helps the communities

 

Rebecca Law

Rebecca graduated from University of San Francisco with a degree in applied economics, focusing on marketing, program management and event management. Her experience is unmatched when it comes to aligning program scope with strategic business objectives. Rebecca has an extensive background in managing marketing campaigns and is highly skilled at communicating with a variety of audiences.

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