Outcomes of patients with SCD and severe acute parvovirus B19 infection admitted to the ICU
| . | NA . | Overall . | Erythroblastopenia . | BMN / CFE . | Other VO manifestations . | P value . |
|---|---|---|---|---|---|---|
| N = 61 . | n = 26 . | n = 17 . | n = 18 . | |||
| Vasopressor support | 0 | 19 (31.1) | 2 (7.7) | 12 (70.6) | 5 (27.8) | <.001 |
| Acute cor pulmonale | 0 | 20 (32.8) | 1 (3.8) | 12 (70.6) | 7 (38.9) | <.001 |
| High-flow oxygen therapy | 0 | 15 (24.6) | 2 (7.7) | 6 (35.3) | 7 (38.9) | .03 |
| Noninvasive ventilation | 0 | 7 (11.5) | 3 (11.5) | 1 (5.9) | 3 (16.7) | .6 |
| Invasive mechanical ventilation | 0 | 22 (36.1) | 2 (7.7) | 13 (76.5) | 7 (38.9) | <.001 |
| Mild to severe ARDS | 0 | 20 (32.8) | 3 (11.5) | 11 (64.7) | 6 (33.3) | .001 |
| IMV duration (d) | 0 | 0 (0-6) | 0 (0-0) | 9 (6-16) | 0 (0-3) | <.001 |
| Prone positioning | 0 | 10 (16.4) | 2 (7.7) | 7 (41.2) | 1 (5.6) | .01 |
| RRT | 0 | 6 (9.8) | 0 (0) | 4 (23.5) | 2 (11.1) | .04 |
| ECLS | 0 | 3 (4.9) | 0 (0) | 1 (5.9) | 2 (11.1) | .2 |
| iNO | 1 | 10 (16.7) | 0 (0) | 6 (37.5) | 4 (22.2) | .01 |
| Exchange transfusion | 0 | 20 (32.8) | 3 (11.5) | 9 (52.9) | 8 (44.4) | .01 |
| Transfusion alone | 0 | 44 (72.1) | 15 (57.7) | 17 (100) | 12 (66.7) | .01 |
| RBC transfusion | 1 | 49 (81.7) | 17 (68) | 17 (100) | 15 (83.3) | .03 |
| Platelet transfusion | 2 | 15 (25.4) | 0 (0) | 11 (68.8) | 4 (22.2) | <.001 |
| Morphine | 1 | 52 (86.7) | 22 (88) | 15 (88.2) | 15 (83.3) | .9 |
| Diagnostics | ||||||
| Pulmonary thrombosis | 0 | 6 (9.8) | 0 (0) | 3 (17.6) | 3 (16.7) | .1 |
| Bone marrow examination | 0 | 22 (36.1) | 3 (11.5) | 15 (88.2) | 4 (22.2) | <.001 |
| BMN | 39 | 12 (54.5) | 0 (0) | 12 (85.7) | 0 (0) | .001 |
| Neurological manifestation | 0 | 19 (31.1) | 3 (11.5) | 14 (82.4) | 2 (11.1) | <.001 |
| Cerebral imaging | 0 | 17 (27.9) | 2 (7.7) | 13 (76.5) | 2 (11.1) | <.001 |
| CFE | 44 | 12 (70.6) | 0 (0) | 12 (92.3) | 0 (0) | .002 |
| Acute anemia | 0 | 56 (91.8) | 25 (96.2) | 15 (88.2) | 16 (88.9) | .6 |
| Thrombopenia, <150 × 109/L | 0 | 34 (55.7) | 0 (0) | 17 (100) | 17 (94.4) | <.001 |
| Hepatitis∗ | 0 | 48 (78.7) | 16 (61.5) | 17 (100) | 15 (83.3) | .01 |
| Myocarditis | 0 | 1 (1.6) | 0 (0) | 0 (0) | 1 (5.6) | .3 |
| Macrophagic activation syndrome | 0 | 1 (1.6) | 0 (0) | 1 (5.9) | 0 (0) | .3 |
| Parvovirus treatment | ||||||
| IVIg or plasma exchange | 0 | 15 (24.6) | 6 (23.1) | 6 (35.3) | 3 (16.7) | .4 |
| Erythropoietin | 1 | 19 (31.7) | 9 (36) | 6 (35.3) | 4 (22.2) | .6 |
| In-ICU death | 0 | 5 (8.2) | 0 (0) | 3 (17.6) | 2 (11.1) | .1 |
| ICU length of stay, d | 0 | 7 (4-11) | 5.5 (3-9) | 11 (9-28) | 6 (3-7) | <.001 |
| Hospital length of stay, d | 2 | 15 (10-24) | 11 (9-20) | 28 (19-41) | 13 (8-20) | .001 |
| . | NA . | Overall . | Erythroblastopenia . | BMN / CFE . | Other VO manifestations . | P value . |
|---|---|---|---|---|---|---|
| N = 61 . | n = 26 . | n = 17 . | n = 18 . | |||
| Vasopressor support | 0 | 19 (31.1) | 2 (7.7) | 12 (70.6) | 5 (27.8) | <.001 |
| Acute cor pulmonale | 0 | 20 (32.8) | 1 (3.8) | 12 (70.6) | 7 (38.9) | <.001 |
| High-flow oxygen therapy | 0 | 15 (24.6) | 2 (7.7) | 6 (35.3) | 7 (38.9) | .03 |
| Noninvasive ventilation | 0 | 7 (11.5) | 3 (11.5) | 1 (5.9) | 3 (16.7) | .6 |
| Invasive mechanical ventilation | 0 | 22 (36.1) | 2 (7.7) | 13 (76.5) | 7 (38.9) | <.001 |
| Mild to severe ARDS | 0 | 20 (32.8) | 3 (11.5) | 11 (64.7) | 6 (33.3) | .001 |
| IMV duration (d) | 0 | 0 (0-6) | 0 (0-0) | 9 (6-16) | 0 (0-3) | <.001 |
| Prone positioning | 0 | 10 (16.4) | 2 (7.7) | 7 (41.2) | 1 (5.6) | .01 |
| RRT | 0 | 6 (9.8) | 0 (0) | 4 (23.5) | 2 (11.1) | .04 |
| ECLS | 0 | 3 (4.9) | 0 (0) | 1 (5.9) | 2 (11.1) | .2 |
| iNO | 1 | 10 (16.7) | 0 (0) | 6 (37.5) | 4 (22.2) | .01 |
| Exchange transfusion | 0 | 20 (32.8) | 3 (11.5) | 9 (52.9) | 8 (44.4) | .01 |
| Transfusion alone | 0 | 44 (72.1) | 15 (57.7) | 17 (100) | 12 (66.7) | .01 |
| RBC transfusion | 1 | 49 (81.7) | 17 (68) | 17 (100) | 15 (83.3) | .03 |
| Platelet transfusion | 2 | 15 (25.4) | 0 (0) | 11 (68.8) | 4 (22.2) | <.001 |
| Morphine | 1 | 52 (86.7) | 22 (88) | 15 (88.2) | 15 (83.3) | .9 |
| Diagnostics | ||||||
| Pulmonary thrombosis | 0 | 6 (9.8) | 0 (0) | 3 (17.6) | 3 (16.7) | .1 |
| Bone marrow examination | 0 | 22 (36.1) | 3 (11.5) | 15 (88.2) | 4 (22.2) | <.001 |
| BMN | 39 | 12 (54.5) | 0 (0) | 12 (85.7) | 0 (0) | .001 |
| Neurological manifestation | 0 | 19 (31.1) | 3 (11.5) | 14 (82.4) | 2 (11.1) | <.001 |
| Cerebral imaging | 0 | 17 (27.9) | 2 (7.7) | 13 (76.5) | 2 (11.1) | <.001 |
| CFE | 44 | 12 (70.6) | 0 (0) | 12 (92.3) | 0 (0) | .002 |
| Acute anemia | 0 | 56 (91.8) | 25 (96.2) | 15 (88.2) | 16 (88.9) | .6 |
| Thrombopenia, <150 × 109/L | 0 | 34 (55.7) | 0 (0) | 17 (100) | 17 (94.4) | <.001 |
| Hepatitis∗ | 0 | 48 (78.7) | 16 (61.5) | 17 (100) | 15 (83.3) | .01 |
| Myocarditis | 0 | 1 (1.6) | 0 (0) | 0 (0) | 1 (5.6) | .3 |
| Macrophagic activation syndrome | 0 | 1 (1.6) | 0 (0) | 1 (5.9) | 0 (0) | .3 |
| Parvovirus treatment | ||||||
| IVIg or plasma exchange | 0 | 15 (24.6) | 6 (23.1) | 6 (35.3) | 3 (16.7) | .4 |
| Erythropoietin | 1 | 19 (31.7) | 9 (36) | 6 (35.3) | 4 (22.2) | .6 |
| In-ICU death | 0 | 5 (8.2) | 0 (0) | 3 (17.6) | 2 (11.1) | .1 |
| ICU length of stay, d | 0 | 7 (4-11) | 5.5 (3-9) | 11 (9-28) | 6 (3-7) | <.001 |
| Hospital length of stay, d | 2 | 15 (10-24) | 11 (9-20) | 28 (19-41) | 13 (8-20) | .001 |
ARDS, acute respiratory distress syndrome; ECLS, extracorporeal life support; IMV, invasive mechanical ventilation; iNO, inhaled nitric oxide; IVIg, intravenous immunoglobulin; RBC, red blood cell; RRT, renal replacement therapy; VO, vaso-occlusive.
Transaminase elevation.