Seroprevalence of SARS-CoV-2 antibodies among sickle cell patients in Burkina Faso

Abstract

Introduction: Like all countries in the world, sub-Saharan Africa has been affected by the COVID-19 pandemic. The socio-economic impact of the crisis has affected the health system, pushing certain health priorities into the background. In sub-Saharan Africa, the disease remains a major problem, with the highest incidence and lethality. It causes severe clinical manifestations and decreased immunity in patients, making them susceptible to significant morbidity and mortality related to COVID-19. The aim of this study was to determine the seroprevalence of SARS-CoV-2 antibodies and the risk factors in sickle cell patients in Burkina Faso. Patients and methods: We conducted a cross-sectional study in three sickle cell disease (SCD) reference centers in Ouagadougou from November to December 2021 and one center in Bobo-Dioulasso from July to October 2022. Patients of any age and gender attending these SCD centers were included. Sociodemographic and clinical data were collected from the patient's clinical record; SARS-CoV-2 IgG/IgM screening were performed using rapid diagnostic test. Results: A total of 304 patients (151 from Ouagadougou and 153 from Bobo-Dioulasso) with a median age of 12 years and a sex-ratio (M/F) of 0.82 were included. The median age at diagnosis of SCD was 4 years and the acute complications were the main circumstances of diagnosis (83.5%). The majority (55.6%) were SS homozygotes. The overall crude seroprevalence (IgM or IgG) was 57.9%. After adjustment for the sensitivity and specificity of the kit used, the seroprevalence was 69.1% (95% CI [65.5-72.6]). The positivity to SARS-CoV-2 antibodies was 2.51-fold (p=0.005), 3.25-fold (p=0.004) and 2.85-fold (p=0.027) higher in patients aged 10-19, 20-29 and 30-39 years respectively, compared to those under 10 years. History of recurrent vaso-occlusive crises in the last 12 months was also associated with SARS-CoV-2 seropositivity (OR=2.18; 95% CI [1.18-4.05], p=0.013). Conclusion: SCD patients, like the general population, were affected by the COVID-19 pandemic. Given their relative immunosuppression and comorbidities, it is necessary to promote protective measures against COVID-19, including vaccination, in these patients.