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With the outbreak of the Coronavirus Disease 2019 (COVID\u201019) pandemic, which also primarily results in acute respiratory illness, the clinical picture and treatment outcome in SCD patients with ACS remain unknown. We present a case of a 30\u2010year\u2010old male who came in with features of painful vaso\u2010occlusive episode and haemolysis that later evolved to acute chest syndrome. Chest X\u2010ray showed pneumonic changes and mild bilateral pleural effusion, and nasal Reverse Transcription\u2010Polymerase Chain Reaction (RT\u2010PCR) for COVID\u201019 test came out positive. He was managed supportively with simple transfusion, antibiotics, dexamethasone and oxygen support with a good clinical outcome. Presenting with non\u2010specific symptoms and similar respiratory symptoms and signs, the clinical picture of COVID\u201019 can prove difficult to discern from that of ACS due to other causes. This report emphasizes a need for a higher index of suspicion whenever a SCD patient presents with symptoms of acute respiratory distress.<\/jats:p>","DOI":"10.1002\/jha2.397","type":"journal-article","created":{"date-parts":[[2022,2,8]],"date-time":"2022-02-08T04:09:05Z","timestamp":1644293345000},"page":"507-512","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Acute chest syndrome and COVID\u201019 in hydroxyurea na\u00efve sickle cell disease patient in a low resource setting"],"prefix":"10.1002","volume":"3","author":[{"given":"William Frank","family":"Mawalla","sequence":"first","affiliation":[{"name":"Department of Haematology and Blood Transfusion Muhimbili University of Health and Allied Sciences  Dar es Salaam Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahlam","family":"Nasser","sequence":"additional","affiliation":[{"name":"Department of Haematology and Blood Transfusion 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