Clinical course of COVID-19 in patients with splenectomy

Objective: Although splenectomy develops spontaneously in sickle cell disease; ıt is used as an effective treatment method in trauma and some hematological diseases. In this study, our aim was to determine the risk of COVID-19 infection, hospitalization and survival parameters in splenectomy patients/individuals who are known to be more severely affected by infectious agents than individuals with preserved splenic function. We also aimed to investigate the serological response to SARS-CoV-2 infection and vaccination in this patient group. Materials and Methods: A total of 130 patients with splenectomy, who were admitted to Çukurova University Faculty of Medicine Balcalı Hospital Adult Hematology outpatient clinic between June 2022 and January 2023, and who met the study conditions, were included in the study. Epidemiological data, demographic information, clinical characteristics (cause of splenectomy, COVID-19 infection and vaccination status), laboratory and imaging data were collected by analyzing the medical records of the patients. ECLIA method was used for the quantitative determination of high-affinity antibodies against SARS-CoV-2. Statistical analysis was performed using the SPSS (version 22.0) software program for Windows. Results: In 130 people included in the study, the frequency of diagnosis of COVID-19 was 37,7%, the frequency of hospitalization was determined as 40,8%. Complications developed in 10 patients during their follow-up, and the most common ones were arrhythmia and thromboembolism. The lymphocyte and thrombocyte values measured during the COVID-19 infection period were found significantly lower than pre-infection values (p<0,05). Acute phase reactants CRP, ferritin and coagulation parameters d-dimer and fibrinogen were found to be significantly higher (p<0,001). A significant, positive correlation was detected between antibody level and vaccine dose. Antibody levels of those who had an infection and were vaccinated were higher than those who had an infection but were not vaccinated, which was statistically significant(p=0.030). Conclusion: The severity of COVİD-19 infection and the frequency of hospitalization have increased in individuals with splenectomy due to accompanying comorbidities. Serologic response after COVID-19 infection and/or vaccination was shown to occur in splenectomized patients. Keywords: COVID-19, splenectomy, humoral immune response, Anti-SARS CoV-2 IgG