Researchers reported the cases of 2 patients with sickle cell disease (SCD) who developed devastating neurologic complications following SARS-CoV-2 infection, which ended in brain edema and death.

The study published in the Journal of Investigative Medicine High Impact Case Reports highlights the risk of neurologic injury due to COVID-19 patients with SCD. It underscores the importance of recognizing the signs of neurological injury promptly so quick intervention can be attempted. It also highlights the importance of COVID-19 vaccination in these patients.

“The goal for sharing the details of these 2 cases is to draw attention to the fact that sickle cell disease patients can present with vaso-occlusive crises as their sole manifestation of the COVID-19 infection, and that they may be at increased risk of developing catastrophic neurologic injury due to COVID-19,” the authors said.

It is now well-understood that SARS-CoV-2 infection can cause neurological complications. People with SCD are already at a higher risk of neurological conditions and cardiological and pulmonary comorbidities that put them at a higher risk of poor outcomes following infections.

Read more about the comorbidities of SCD

Here, a team of researchers led by Morgan McLemore, MD, described the case of 2 patients with SCD who both had COVID-19 before any vaccine was available. Both patients developed vaso-occlusive crises and were treated with opiates and hydration, which is the standard of care. However, doctors did not recognize that their vaso-occlusive crisis was due to COVID-19 until later.

The first patient underwent plasma exchange and the second received simple transfusions. “Exchange transfusion should be considered early during the course of symptomatic COVID-19 infection in [SCD] patients, as it may significantly improve their clinical outcomes,” the researchers concluded.


Clarke K, Benameur K, Wiley Z, et al. Catastrophic neurological complications in 2 patients with sickle cell disease and COVID-19. J Investig Med High Impact Case Rep. Published online July 18, 2022. doi:10.1177/23247096221111778