Glucose‐6‐phosphate dehydrogenase deficiency‐associated hemolysis and methemoglobinemia in a <scp>COVID</scp>‐19 patient treated with chloroquine

Kuipers, Maria T.; Zwieten, Rob van; Heijmans, Jarom; Rutten, Caroline E.; Heer, Koen de; Kater, A. P.; Nur, Erfan

doi:10.1002/ajh.25862

Cited by 22 publications

(29 citation statements)

References 6 publications

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“…Based on the inclusion and exclusion criteria, seven duplicates were removed and 187 articles were excluded after abstract review. After the full set of remaining articles was screened, seven reports were finally included in the present study [ 17 , 18 , 19 , 20 , 21 , 22 , 23 ]. The study selection process is shown in Figure 1 a.…”

Section: Resultsmentioning

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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Section: Resultsmentioning

confidence: 99%

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

Scholkmann

Restin

Ferrari

et al. 2020

JCM

View full text Add to dashboard Cite

show abstract

“…The potential use of HCQ against COVID-19 may raise safety issues in certain populations [132]. Recent reports suggest that CQ or HCQ is possibly linked to hemolysis in G6PD deficiency [133][134][135]. However, two large retrospective studies indicated that no episode of hemolysis was found after HCQ treatment among G6PD-deficient individuals [136,137].…”

Section: Potential Influence Of G6pd Deficiency On Covid-19 Therapiesmentioning

confidence: 99%

G6PD deficiency, redox homeostasis, and viral infections: implications for SARS-CoV-2 (COVID-19)

Yang

Tjong

et al. 2021

Free Radical Research

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“…Thus, intravascular hemolysis and methemoglobinemia has been observed in SARS-CoV-2 patients with Glucose-6-phosphate dehydrogenase (G6PD) deficiency [ 156 ], probably induced by oxidative stress in SARS-CoV-2 infection/COVID-19. Moreover, TMPRSS2 and cathepsin L, chloroquine and hydroxychloroquine are supposed to trigger severe drug-induced haemolytic anaemia in G6PD-deficient patients [ 157 , 158 , 159 ]. Although hydroxychloroquine is considered to be safe in therapeutic doses in class II or III G6PD deficiency, an increased risk of severe adverse effects is supposed to be present in patients suffering from SARS-CoV-2 infection/COVID-19.…”

Section: Lysosomotropic Active Compounds In Clinical Trialsmentioning

confidence: 99%

COVID-19/SARS-CoV-2 Infection: Lysosomes and Lysosomotropism Implicate New Treatment Strategies and Personal Risks

Blaess

Kaiser

Sauer

et al. 2020

IJMS

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In line with SARS and MERS, the SARS-CoV-2/COVID-19 pandemic is one of the largest challenges in medicine and health care worldwide. SARS-CoV-2 infection/COVID-19 provides numerous therapeutic targets, each of them promising, but not leading to the success of therapy to date. Neither an antiviral nor an immunomodulatory therapy in patients with SARS-CoV-2 infection/COVID-19 or pre-exposure prophylaxis against SARS-CoV-2 has proved to be effective. In this review, we try to close the gap and point out the likely relationships among lysosomotropism, increasing lysosomal pH, SARS-CoV-2 infection, and disease process, and we deduce an approach for the treatment and prophylaxis of COVID-19, and cytokine release syndrome (CRS)/cytokine storm triggered by bacteria or viruses. Lysosomotropic compounds affect prominent inflammatory messengers (e.g., IL-1B, CCL4, CCL20, and IL-6), cathepsin-L-dependent viral entry of host cells, and products of lysosomal enzymes that promote endothelial stress response in systemic inflammation. As supported by recent clinical data, patients who have already taken lysosomotropic drugs for other pre-existing conditions likely benefit from this treatment in the COVID-19 pandemic. The early administration of a combination of antivirals such as remdesivir and lysosomotropic drugs, such as the antibiotics teicoplanin or dalbavancin, seems to be able to prevent SARS-CoV-2 infection and transition to COVID-19.

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Glucose‐6‐phosphate dehydrogenase deficiency‐associated hemolysis and methemoglobinemia in a COVID‐19 patient treated with chloroquine

Cited by 22 publications

References 6 publications

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

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

G6PD deficiency, redox homeostasis, and viral infections: implications for SARS-CoV-2 (COVID-19)

COVID-19/SARS-CoV-2 Infection: Lysosomes and Lysosomotropism Implicate New Treatment Strategies and Personal Risks

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