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To the Editor: As the coronavirus disease 2019 (COVID-19) pandemic continues, there is an increasing focus on the impact of patient comorbidities on disease presentation and clinical course. Patients with sickle cell disease (SCD) who are infected with COVID-19 may have a significant risk of developing acute chest syndrome (ACS), a potentially lifethreatening complication. We report on the first documented case of a hospitalized patient with SCD who developed ACS with COVID-19.

A 21-year-old man with a history of SCD (HbS/β0-thalassemia) on maintenance hydroxyurea therapy presented to our emergency department, with worsening left hip pain over four months. His prior history was notable for an episode of ACS two years before presentation requiring simple blood transfusion, plus multiple pain crises and septic arthritis of the right hip. After an MRI showed evidence of avascular necrosis of the left hip, he …