Direct and indirect effects of COVID 19 on thalassemia care in an adult
thalassaemia care unit in Sri Lanka
Abstract
Patients with thalassemia syndromes(TS) affected with COVID 19 attending
a thalassemia center in Sri Lanka situated in the region most affected
with COVID 19 were studied over a 16- month period. To assess the
collateral effects on overall thalassemia care in the center, data on
transfusion, chelation, clinic attendance was analyzed. Morbidity events
and deaths recorded during the COVID 19 period and a similar period
before the beginning of COVID 19 infection in Sri Lanka too were
reordered in all clinic registrants. Seven patients (of 502) with TS had
developed COVID 19 during the 16-month period and all were minimally
symptomatic and had recovered without complications. Number of monthly
clinic visits reduced from 338 in pre-COVID19 to 268 during COVID-19 (P
= 0.004). Iron chelators usage too reduced during pandemic period (P
< 0.001). Though admissions related to morbidity reduced
during the pandemic (58 vs 16, P <0.001) there were more non
COVID19 deaths (8 vs 4). Numbers affected with COVID 19 and the severity
of infection seemed milder in this cohort of patients with TS but the
collateral effects on the management of the unit and its effects on
mortality in this vulnerable population appears to have been
substantial.