Effects of Beta-Thalassemia on COVID-19 Outcomes

Abstract

Beta-thalassemia is a hemoglobinopathy caused by mutations in the beta-globin chain. This disrupts hemoglobin production and can potentially result in severe anemia. There has been a rise in COVID-19 cases over the last 2 years, with a predominant effect on the respiratory and vascular systems of the body. Since beta-thalassemia is the most common inherited single-gene disorder in the world, investigating the impact of COVID-19 on these patients is important. Some theories suggest that patients with beta-thalassemia will be more susceptible to COVID-19 and have worse outcomes due to their underlying comorbid conditions. However, majority of the literature found that beta-thalassemia is protective against COVID-19. This could be because SARS-CoV-2 proteins can attack the beta chain of normal hemoglobin, resulting in impaired oxygen transfer and increased ferritinemia. Thus, in hemoglobinopathies with beta-chain defects and low hepcidin levels, susceptibility to COVID-19 infection is potentially decreased. Higher levels of Hemoglobin F in thalassemia patients may also be protective against viral infections. Surprisingly, most studies and case reports focus on patients with beta-thalassemia major. There is yet much to learn about the outcomes of patients with thalassemia minor and other hemoglobinopathies.