COVID-19 in patients with transfusion dependent thalassemia in Indonesia: characteristics of the disease and patients, and comparison between epidemiological data for COVID-19 and thalassemia in Indonesia and South-East Asia

Abstract

Background: People living with transfusion dependent thalassemia have high risk of getting infected by COVID-19. This can be caused by both several factors. Chronic complications of thalassemia also render them more vulnerable to infectious diseases, including COVID-19. However, anecdotal data shows that Thalassemia patients less incidence of COVID-19 compared to the general population. Patients and methods: This research used a cross sectional design. The study was conducted at the Division of Haematology and Medical Oncology of the Cipto Mangunkusumo Hospital in Jakarta from May 2020 – August 2021. Total sampling method was used involving all Thalassemia Major patients who had been infected with COVID-19 obtained directly from medical record and through the thalassemia patients-parents foundation Results: From 10,397 patients with thalassemia, 72 (0.69%) people were infected by COVID-19 and 7 (9.7%) were deceased. Meanwhile, the incidence of COVID-19 in general population of Indonesia was 0.87%, more than in the thalassemia population. This means that thalassemia might provide protection against COVID-19 due to several mechanism. Conclusion: Indonesia and other countries with high prevalence of thalassemia have lower COVID-19 incidence than countries with low prevalence of thalassemia. Thalassemia might have protective effect against COVID-19. Well designed studies are needed to provide better evidence on the protective effect of thalassemia on COVID-19.

Keywords

• COVID-19
• blood transfusion
• transfusion-dependent thalassemia
• HbE
• beta-thalassemia