The analysis of a retrospective longitudinal cohort of individuals from a national database of commercial insurance plans revealed a significant comorbidity burden of sickle cell disease (SCD) across all age groups.

“We found very high prevalence rates for conditions that are characteristic of this condition, particularly in persons under age 18,” the study’s authors said. “For older age groups, comorbidities that are common in non-SCD patients, but made more common or more severe by SCD, increased substantially to levels that are significantly higher than those seen in persons without the disease.” These included chronic pain, cardiovascular conditions such as pulmonary hypertension, and renal disease.

The analysis from the Truven Health MarketScan Commercial Claims and Encounters Database found that the most prevalent conditions in patients younger than 18 years (n=7502) were vaso-occlusive pain (59%) and nonspecific infections (57%), fever (50%), and acute chest syndrome (29%). The results were similar for patients aged 18 to 45 years (n=10,183), with vaso-occlusive pain (56%) and nonspecific infections (51%) being the 2 most prevalent conditions, followed by cardiovascular conditions such as pulmonary hypertension (28%). In patients aged 46 to 64 years (n=4459), the top 3 most prevalent comorbidities were nonspecific infections (52%), cardiovascular conditions such as pulmonary hypertension (46%), and vaso-occlusive pain (40%).

Vaso-occlusive pain, infections, and acute chest syndrome accounted for the most inpatient services when considering place of service, whereas nonspecific infections, vaso-occlusive pain, and fever were the most common comorbidities when considering all places of services.

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Males generally presented higher prevalence of complications compared with females, except for infections, fatigue, and chronic mental health disorders.

The study included 20,206 patients with SCD (median age, 24 years, 57.3% female).


Ramsey SD, Bender MA, Li L, et al. Prevalence of comorbidities associated with sickle cell disease among non-elderly individuals with commercial insurance–a retrospective cohort study. PLoS One. 2022;17(11):e0278137.