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
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?
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?
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 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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