G6PD Deficiency and COVID-19 Public Information

Revised 08/2020

LETS STAY HEALTHY…

IF YOU HAVE G6PD DEFICIENCY HERE ARE IMPORTANT TIPS TO STAY HEALTHY!
  • Sleep and eat well … stay away from harmful triggers
  • Wash hands frequently, avoid physical contact with others, and follow safe social procedures to avoid getting sick with an infection when with others. Just because you are G6PD deficient does not mean you will be treated for severe symptoms of COVID-19 if exposed. Whether you are G6PD deficient or not, there are many health related variables that will determine how your body will fight off infections.
  • If you are hospitalized, please make sure you tell everyone that you have G6PD Deficiency and to put it in your chart as an allergy. (That is the first place a medical professional will look before treatment of any kind ) Wear a G6PD Deficiency Rx alert bracelet.
  • Discuss all treatments and your concerns of their risk because you are G6PD deficient. It is important to weigh the risks and benefits of using questioned contraindications on a case-by-case approach for patients with G6PD Deficiency.
  • Request screening for G6PD Deficiency if you are concerned that you might be G6PD deficient.

The COVID-19 pandemic has impacted almost every part of the world. This has led to a public health crisis that has resulted in severe economic and social strife. As scientists continue to research effective treatments and SARCoV-2 vaccines that can prevent future infections, some are wondering if there are genetic predispositions that make it more likely for someone to be more susceptible to contracting or exhibiting more severe symptoms of COVID-19. One such example is patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Here are questions that need more research to have a valid answer.

We will continue to update this page as we learn more to find a resolution to these concerns.

Are People with G6PD Deficiency at Higher Risk for COVID-19?

FACT: Treating for COVID-19 is alarming when a SARCoV-2 virus-infected patient has symptoms of severe oxidative state of health.

COVID-19 initiates a pro-inflammatory, systemic response. Inflammation is known to lead to oxidative stress.1  This leads to an overproduction of free oxygen radicals. These radicals further stimulate systemic inflammatory response syndrome.

FACT: Sometimes having G6PD Deficiency can lead to high oxidative stress that can manifest into hemolysis and complications from it.2 -7

Infection is the most common cause of acute hemolysis in G6PD-deficient persons.8 To date, case studies that have explicitly examined G6PD Deficiency and SARCoV-2 virus are rare; however, a laboratory study published in 2008 takes a closer look at the impact of its sister virus, human coronavirus HCoV229E on cells with G6PD Deficiency.9 It was concluded that there was a markedly increased amount of oxidant production, demonstrating cell stress. The researchers also found that the rate of viral replication was higher in infected cells that lacked G6PD and if an antioxidant was added less cell death was seen. Thus this shows that issues related to oxidative stress played a direct cause in cell death by coronavirus HCoV229E.

Is G6PD Deficiency at Higher Risk for COVID-19 complications due to Treatment?

FACT: G6PD Deficiency has been reported in cases of patients treated for COVID-1910,11

Keep in mind these cited cases are of patients with other underlying health issues.

FACT: Antimalarial drugs and other contraindications for G6PD Deficiency are being used for treating COVID-19

Most popular antimalarial drugs in COVID-19 Clinical Trials are Chloroquine and Hydroxychloroquine*. Methylene Blue, Vitamin C, NSAIDs, and other known contraindications are also being used as treatment.
*Please take note Hydroxychloroquine has been reported in cases as a cause for hemolysis and other studies say it is safe. Hopefully, soon we will know this answer. Chloroquine has been reported unsafe for G6PD Deficiency!12-14

WE NEED MORE RESEARCH…

As this global pandemic rages on, there are hundreds of millions of people who could be more susceptible to COVID-19 than the average person. That is why the world needs scientific studies analyzing these relationships and not merely hypotheses.

What Can You Do?

BE CAUTIOUS… Knowing you have G6PD Deficiency will help the plan of action for treatment if you do get sick.

It is important to discuss with your medical provider in regards to this matter. There is a Medical Research Review that all medical professionals should read to learn more about COVID-19 & G6PD Deficiency.

G6PDd population has the right to know more about COVID19 & G6PD Deficiency treatment outcomes. There is a petition you can sign to join forces.

The COVID-19 & G6PD Deficiency Task Force sent to The World Health Organization a letter of request addressing such concerns.

TELL US YOUR STORY with COVID-19 & G6PD Deficiency. All can learn from your experience.

Please feel free to contact us in regards to any matter concerning G6PD Deficiency

Cited References:

  1. Marie-Pierrette Ntyonga-Pono1,&. COVID-19 infection and oxidative stress: an under-explored approach for prevention and treatment?
  2. Albertsen J, Ommen HB, Wandler A, Munk K. Fatal haemolytic crisis with microvascular pulmonary obstruction mimicking a pulmonary embolism in a young African man with glucose-6-phosphate dehydrogenase deficiency. BMJ Case Rep. Published online: April 8, 2014. doi: 10.1136/bcr-2013-201432.
  3. Khalid K Alharbi, Imran Ali Khan,* and Rabbani Syed Thrombophilic gene polymorphism studies in G6PD deficient individuals from Saudi population.
  4. P A Thompson  1 , E Chew, J Szer Deep vein thrombosis in association with acute intravascular haemolysis in glucose-6-phosphate dehydrogenase deficiency: a unique case.
  5. Eziokwu A S, Angelini D (March 28, 2018) New Diagnosis of G6PD Deficiency Presenting as Severe Rhabdomyolysis. Cureus 10(3): e2387. doi:10.7759/cureus.2387
  6. Milan Talwar, Sriram Krishnamurthy, Narayanan Parameswaran, C. G. Delhikumar, Satish Haridasan & Bheemanathi Hanuman Srinivas (2019) Severe acute kidney injury owing to rhabdomyolysis and intravascular haemolysis in an 11-year-old child with G6PD deficiency, Paediatrics and International Child Health, 39:2, 150-153, DOI: 10.1080/20469047.2018.1439804
  7. Kimmick G, Owen J. Rhabdomyolysis and hemolysis associated with sickle cell trait and glucose-6-phosphate dehydrogenase deficiency. South Med J. 1996;89(11):1097-1098. doi:10.1097/00007611-199611000-00015
  8. JENNIFER E. FRANK, MAJ, MC, USA, Martin Army Community Hospital, Fort Benning, Diagnosis and Management of G6PD Deficiency.  Georgia. Am Fam Physician. 2005 Oct 1;72(7):1277-1282.
  9. Yi-Hsuan Wu,  Ching-Ping Tseng,  Mei-Ling Cheng,  Hung-Yao Ho, Shin-Ru Shih,  Daniel Tsun-Yee Chiu Glucose-6-Phosphate Dehydrogenase Deficiency Enhances Human Coronavirus 229E Infection . Author Notes. The Journal of Infectious Diseases, Volume 197, Issue 6, 15 March 2008, Pages 812–816, https://doi.org/10.1086/528377
  10. T. Kuipers, MD, PhD R. van Zwieten, PhD,  J. Heijmans, MD, PhD,  C.E. Rutten, MD, PhD,  K. de Heer, MD,  A.P. Kater, MD, PhD,  and E. Nur, MD, PhD G6PD deficiency‐associated hemolysis and methemoglobinemia in a COVID‐19 patient treated with chloroquine. Am J Hematol. 2020 May 2020 May10 10.1002/ajh.25862.doi: 10.1002/ajh.25862PMCID: PMC7273001PMID:32390140
  11. Beauverd Y, Adam Y, Assouline B, et al. COVID-19 infection and treatment with hydroxychloroquine cause severe haemolysis crisis in a patient with glucose-6-phosphate dehydrogenase deficiency. Eur J Haematol. 2020. doi: 10.1111/ejh.13432
  12. Arese P, De Flora A.Pathophysiology of hemolysis in glucose‐6‐phosphate de‐hydrogenase deficiency. Semin Hematol. 1990;27(1):1‐40. [PubMed] [Google Scholar]
  13. Stokkermans TJ, Trichonas G. Chloroquine and hydroxychloroquine. StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing; 2020. [Google Scholar]
  14. Kassi, Eva N et al. “G6PD and chloroquine: Selecting the treatment against SARS-CoV-2?.” Journal of cellular and molecular medicine 24,9 (2020): 4913-4914. doi:10.1111/jcmm.15312