Doubtful precipitation of hemolysis by hydroxychloroquine in glucose‐6‐phosphate dehydrogenase‐deficient patient with COVID‐19 infection

Afra, T. P.; Nampoothiri, Ram Vasudevan; T, Muhammed Razmi

doi:10.1111/ejh.13460

Cited by 12 publications

(7 citation statements)

References 7 publications

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“…Apart from this, COVID-19 infection poses an important confounding factor here, since the infections are the most common trigger for hemolysis in G6PD-deficiency [4]. In a similar report by Beauverd et al, [8] hemolysis was observed even before starting hydroxychloroquine, in a G6PD-deficient COVID-19 patient [9].…”

mentioning

confidence: 80%

Linking hydroxychloroquine to hemolysis in a ‘suspected’ glucose-6-phosphate dehydrogenase deficient patient with COVID-19 infection – a critical appraisal

Afra¹,

Nampoothiri

T³

et al. 2020

European Journal of Internal Medicine

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mentioning

confidence: 80%

Linking hydroxychloroquine to hemolysis in a ‘suspected’ glucose-6-phosphate dehydrogenase deficient patient with COVID-19 infection – a critical appraisal

Afra¹,

Nampoothiri

T³

et al. 2020

European Journal of Internal Medicine

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“…Several other cases have subsequently been reported by others [ 45 , 46 , 47 ]. Nevertheless, Mastroianni et al [ 47 ] and Afra [ 48 ], concerning hydroxychloroquine use in G6PD-deficient patients, have indicated that it is difficult to assess the relationship between hydroxychloroquine and hemolysis in COVID-19 patients. With the global spread of COVID-19, especially in regions with a high prevalence of G6PD deficiency, these cases should alert physicians to the possible correlation between G6PD-deficiency and hydroxychloroquine treatment.…”

Section: Discussionmentioning

confidence: 99%

The Role of Methemoglobin and Carboxyhemoglobin in COVID-19: A Review

Scholkmann

Restin

Ferrari

et al. 2020

JCM

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Following the outbreak of a novel coronavirus (SARS-CoV-2) associated with pneumonia in China (Corona Virus Disease 2019, COVID-19) at the end of 2019, the world is currently facing a global pandemic of infections with SARS-CoV-2 and cases of COVID-19. Since severely ill patients often show elevated methemoglobin (MetHb) and carboxyhemoglobin (COHb) concentrations in their blood as a marker of disease severity, we aimed to summarize the currently available published study results (case reports and cross-sectional studies) on MetHb and COHb concentrations in the blood of COVID-19 patients. To this end, a systematic literature research was performed. For the case of MetHb, seven publications were identified (five case reports and two cross-sectional studies), and for the case of COHb, three studies were found (two cross-sectional studies and one case report). The findings reported in the publications show that an increase in MetHb and COHb can happen in COVID-19 patients, especially in critically ill ones, and that MetHb and COHb can increase to dangerously high levels during the course of the disease in some patients. The medications given to the patient and the patient’s glucose-6-phospate dehydrogenase (G6PD) status seem to be important factors determining the severity of the methemoglobinemia and carboxyhemoglobinemia. Therefore, G6PD status should be determined before medications such as hydroxychloroquine are administered. In conclusion, MetHb and COHb can be elevated in COVID-19 patients and should be checked routinely in order to provide adequate medical treatment as well as to avoid misinterpretation of fingertip pulse oximetry readings, which can be inaccurate and unreliable in case of elevated MetHb and COHb levels in the blood.

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“…This study included four children with G6PD de ciency, three of whom were placed in the severe group. Infections such as COVID-19 can trigger hemolysis of red blood cells in G6PD de ciency patients [31][32][33]. Wu et.al.…”

Section: Discussionmentioning

confidence: 99%

Clinical, Laboratory, and Chest CT Features of Severe Versus Non-Severe Pediatric Patients with COVID‐19 Infection Among Different Age Groups

Hoseinyazdi

Esmaeilian

Jahankhah

et al. 2020

Preprint

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Background: The aim of this study was to compare the clinical, laboratory, and chest computed tomography (CT) findings between severe and non-severe patients as well as between different age groups of pediatric patients with confirmed COVID-19.Method: This study was performed on 55 pediatric patients with confirmed COVID-19 hospitalized in Namazi and Ali Asghar Hospitals, Shiraz, Iran. Patients were divided into severe (n=27) and non-severe (n=28) groups. Also, they were categorized into three age groups: aged less than two years, 3-12 years and 13-17 years. CT scans, laboratory, and clinical features were taken from all patients at the admission time. Abnormal chest CT in COVID-19 pneumonia was found to show one of the following findings: ground-glass opacities (GGO), bilateral involvement, peripheral and diffuse distribution.Result: Fever (79.2%) and dry cough (75.5%) were the most common clinical symptoms. Severe COVID-19 patients showed lymphocytosis compared to non-severe ones (P = 0.028). C-reactive protein (CRP) was shown to be significantly lower in patients aged less than two years than those aged 3-12 and 13-17 years old (P = 0.009). It was also shown that O2 saturation was significantly increased, as age increased (P = 0.015). Also, severe patients had significantly higher CT abnormalities compared to non-severe ones (48.0% compared to 17.9%, respectively) (P = 0.019).Conclusion: Lymphocytosis and abnormal CT findings are among the factors most associated with COVID-19 severity. It was, moreover, showed that the severity of the COVID-19, O2 saturation, and respiratory distress were improved as the age of confirmed COVID-19 pediatric patients increased.

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Doubtful precipitation of hemolysis by hydroxychloroquine in glucose‐6‐phosphate dehydrogenase‐deficient patient with COVID‐19 infection

Cited by 12 publications

References 7 publications

Linking hydroxychloroquine to hemolysis in a ‘suspected’ glucose-6-phosphate dehydrogenase deficient patient with COVID-19 infection – a critical appraisal

Linking hydroxychloroquine to hemolysis in a ‘suspected’ glucose-6-phosphate dehydrogenase deficient patient with COVID-19 infection – a critical appraisal

The Role of Methemoglobin and Carboxyhemoglobin in COVID-19: A Review

Clinical, Laboratory, and Chest CT Features of Severe Versus Non-Severe Pediatric Patients with COVID‐19 Infection Among Different Age Groups

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