Doença Falciforme No Contexto Da Covid-19: Impactos Clínicos E Laboratoriais Do Manejo Terapêutico Com Hidroxiureia

Abstract

Introduction: The COVID-19 pandemic, caused by the SARS-CoV-2 coronavirus, posed a global challenge to healthcare systems, particularly affecting high-risk groups who are more prone to developing severe complications associated with the disease. Among these groups, individuals with sickle cell disease (SCD), a group of hereditary genetic disorders, stand out. In adverse conditions such as hypoxia, SCD leads to hemoglobin polymerization and deformation of red blood cells. These alterations impair tissue oxygenation and contribute to an immunosuppressed state, increasing patients’ susceptibility to infections. Despite limited available data, some studies suggest that the interaction between the viral infection caused by SARS-CoV-2 and the chronic complications of SCD may worsen the clinical prognosis of these patients, resulting in high mortality rates. Considering this, special attention is required not only in diagnosis but especially in the monitoring and treatment of these individuals. From a pharmacological standpoint, therapy with hydroxyurea (HU) has proven to be one of the most effective treatments for SCD. Amid the pandemic scenario, evidence in the literature suggests that HU may help prevent the progression of severe COVID-19 complications in patients with SCD. Objective: Given the scarcity of studies, it is still not possible to assert the exact role of HU in COVID-19 outcomes among individuals with SCD. In this context, the present study aims to review scientific literature integratively to assess the effects of HU in treating these patients, with an emphasis on clinical and laboratory outcomes. Methodology: This is an integrative review conducted using PubMed, MEDLINE, and LILACS databases. The search was carried out using the descriptors “Sickle Cell”, “Sickle Cell Disease”, “COVID-19”, “SARS-CoV-2 Infection”, “Pandemic COVID-19”, and “Hydroxyurea”, covering publications from 2020 to 2024. Results: Following the application of inclusion and exclusion criteria, 15 articles were selected for this review. Conclusion: After data analysis, this review identified heterogeneity in the available evidence regarding the impact of HU on the clinical and laboratory course of COVID-19 in patients with SCD. Although some studies indicate that COVID-19 may act as a trigger for the development of typical SCD complications, resulting in high rates of mortality, hospitalization, and ICU admission, and although HU may improve hematological and inflammatory parameters, there is still no conclusive evidence confirming its effectiveness in the progression of COVID-19 in these patients.