Hemoglobinopathy and COVID-19

Mungmunpuntipantip, Rujittika; Wiwanitkit, Viroj

doi:10.1016/j.htct.2021.04.003

Dear Editor,

We would like to share ideas on the publication “Hemoglobinopathy and pediatrics in the time of COVID-19.¹” Vilela et al. concluded that, “Despite pediatric population with SCD needs more intensive care, the outcome after infection by COVID-19 is favorable.¹” A previous report from Iran noted that patients with thalassemia/hemoglobinopathy had a possible susceptible nature to severe COVID-19.² However, a report from Southeast Asia showed an opposite conclusion.³ Based on the data from our setting, Indochina, where beta-thalassemia and hemoglobin E are very common, only a few cases (less than 5) among more than 20,000 local COVID-19 patients had associated hemoglobinopathy. This marked low incidence might confirm the hypothesis on COVID-19 resistance of patients with hemoglobinopathy. Additionally, all infected cases with underlying hemoglobinopathy usually have mild symptoms. The effect of standard iron chelation therapy in patients with hemoglobinopathy is a possible explanation for mild COVID-19.⁴ Pharmacologically, the iron chelating agent can suppress endothelial inflammation, which is the main pathophysiologic mechanism in COVID-19.⁴

REFERENCES

¹ Vilela TS, Braga JAP, Loggetto SR. Hemoglobinopathy and pediatrics in the time of COVID-19. Hematol Transfus Cell Ther. 2021;43(1):87–100.
² Karimi M, Haghpanah S, Azarkeivan A, Matin S, Safaei A, De Sanctis V. Coronavirus disease 2019 (COVID-19) severity in patients with thalassemias: a nationwide Iranian experience. Mediterr J Hematol Infect Dis. 2021 Jan 1;13(1): e2021008.
³ Papadopoulos KI, Sutheesophon W, Manipalviratn S, Aw TC. A Southeast Asian perspective on the COVID-19 pandemic: hemoglobin E (HbE)-trait confers resistance against COVID-19. Med Sci Monit Basic Res. 2021 Jan 5;27: e929207.
⁴ Dalamaga M, Karampela I, Mantzoros CS. Commentary: could iron chelators prove to be useful as an adjunct to COVID-19 treatment regimens? Metabolism. 2020 Jul;108:154260.

Publication Dates

Publication in this collection
18 Oct 2021
Date of issue
Jul-Sep 2021

History

Received
19 Mar 2021
Accepted
14 Apr 2021
Published
18 May 2021

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivative License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium provided the original work is properly cited and the work is not changed in any way.

[1] ¹ Vilela TS, Braga JAP, Loggetto SR. Hemoglobinopathy and pediatrics in the time of COVID-19. Hematol Transfus Cell Ther. 2021;43(1):87–100.

[2] ² Karimi M, Haghpanah S, Azarkeivan A, Matin S, Safaei A, De Sanctis V. Coronavirus disease 2019 (COVID-19) severity in patients with thalassemias: a nationwide Iranian experience. Mediterr J Hematol Infect Dis. 2021 Jan 1;13(1): e2021008.

[3] ³ Papadopoulos KI, Sutheesophon W, Manipalviratn S, Aw TC. A Southeast Asian perspective on the COVID-19 pandemic: hemoglobin E (HbE)-trait confers resistance against COVID-19. Med Sci Monit Basic Res. 2021 Jan 5;27: e929207.

[4] ⁴ Dalamaga M, Karampela I, Mantzoros CS. Commentary: could iron chelators prove to be useful as an adjunct to COVID-19 treatment regimens? Metabolism. 2020 Jul;108:154260.