Variables evaluated
Data were collected in a database specifically designed for the study.
Data related to cases and controls included baseline characteristics
such as age, gender, SCD type, diagnostic method, parents’ continent of
origin, immunization status (including vaccination againstHaemophilus influenzae type b, Streptococcus pneumoniaeand Neisseria meningitidis serogroups A, B, C, W, Y), penicillin
prophylaxis, treatment with hydroxyurea, other treatments, long-term
central venous catheter (CVC), splenectomy and history of previous
hospital admissions. Clinical data during the episode (only in cases)
included duration of fever before admission, maximum axillary
temperature during the episode, respiratory symptoms, hemodynamic
instability (defined as hypotension or persistent tachycardia requiring
fluid resuscitation or inotropic drugs) and hypoxemia (<
92%). Laboratory parameters included hemoglobin, WBC, neutrophils and
platelets on admission, initial and maximum CRP and procalcitonin during
the episode, blood cultures, as well as other cultures and viral tests.
Other recorded data were inpatient/outpatient management, antimicrobial
treatment, need for antibiotic change because of unfavorable clinical
course, diagnosis of VOC or acute chest syndrome (ACS), duration of
fever and of hospitalization, pediatric intensive care unit (PICU)
admission and final outcome (hospital discharge or exitus). Cytokine
levels in all cases and controls were also evaluated.