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A Case of COVID-19 in a Patient with Asymptomatic Hemoglobin D Thalassemia and Glucose-6-Phosphate Dehydrogenase Deficiency

Rare co-existance of disease or pathology

Sreethish Sasi, Mohamed A. Yassin, Arun Prabhakaran Nair, Muna S. Al Maslamani

Qatar Department of Internal Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar

Am J Case Rep 2020; 21:e925788

DOI: 10.12659/AJCR.925788

Available online: 2020-06-22

Published: 2020-07-22


#925788

BACKGROUND: Beta-hemoglobinopathies and glucose-6-phosphate dehydrogenase (G6PD) deficiency are genetic disorders that cause hemolytic anemia when exposed to oxidative stress. Their co-existence is, however, not proven to enhance the severity of anemia.
CASE REPORT: We report the case of a young man with no known co-morbidities, who came with fever and cough and was diagnosed with COVID-19 pneumonia. He was found to have hemoglobin D thalassemia and G6PD deficiency during further evaluation. Hydroxychloroquine therapy started initially, was discontinued after 3 doses once the G6PD deficiency was diagnosed. His hospital course showed a mild drop in hemoglobin with evidence of hemolysis on peripheral smear. However, the hemoglobin improved without any need for transfusion.
CONCLUSIONS: Hydroxychloroquine therapy can induce hemolytic crises in patients with underlying G6PD deficiency or hemoglobinopathies and should be avoided or closely monitored. Immediate intervention to stop hydroxychloroquine after 3 doses saved our patient from a major hemolytic crisis. The significance of this case report is that it is the first report that outlines the clinic course of COVID-19 pneumonia in a patient with underlying hemoglobin D disease and G6PD deficiency.

Keywords: COVID-19, Glucosephosphate Dehydrogenase Deficiency, hemoglobinopathies, hydroxychloroquine, SARS Virus



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