Clinical perspective on the impact of coronavirus (COVID-19) pandemic on individuals with glucose -6- phosphate dehydrogenase deficiency (G6PD)

Abstract

Trends Med, 2017 Volume 3: 1-2 Glucose-6-phosphate dehydrogenase (G6PD) is an enzyme that catalyzes the initial and the rate-limiting reaction step in the pentose phosphate pathway (HMP) which converts NADP into NADPH. NADPH is required for the generation of reduced glutathione an important antioxidant used to protects red blood cells from oxidative damage.Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common enzymopathy worldwide, affecting an estimated 400 million people and exists in concentrated regions in Africa, the Middle East, and Southeast Asia, and about one in 10 African-American males are affected in the United States [1-3]. G6PD-deficient patients may develop acute hemolytic anemia after exposure to oxidative stress because the HMP shunt is their only source of NADPH. Oxidative stress constitutes a failure of anti-oxidation defence systems to keep reactive oxygen and nitrogen species under control due to decrease of reduced glutathione synthesis in G6PD-deficient patients [4]. Hemolytic anemia may be life-threatening in some individuals due to three main triggers for hemolytic anemia in G6PD-deficient patients these are bacterial or viral infections, certain foods, and certain drugs [5]. These factors can increase the levels of reactive oxygen species, causing red blood cells to be destroyed faster than the body can replace them. Investigators found that G6PD-deficient cells were more susceptible to infection and death by human coronavirus, HCoV229E, a common pathogen for respiratory tract infection [6].In previous study we noticed a concurrent decrease in the concentration of reduced glutathione when the G6PD activity decreased [7]. Furthermore, we presented evidence that maintaining glutathione levels may help in easing the symptoms of certain diseases and supplementation of bilingual glutathione as a therapeutic strategy [8]. Since the onset of the COVID-19 pandemic and in light of the notion that some people become severely ill while others are asymptomatic, researchers started to believe that people who have a G6PD deficiency may be significantly affected by COVID-19 pandemic like the human coronavirus, HCoV229E and raised the question: Is there any scientific evidences to support a correlation/ association between G6PD deficiency and COVID-19 infection, susceptibility, severity or mortality [9]. Recent retrospective studies strongly suggesting that G6PD-deficient COVID-19 patients may suffer highest chloroquine induced toxicity a drug along with hydroxychloroquine are commonly prescribed widely used worldwide in the treatment of COVID-19 pandemic [10,11]. Moreover, a brief overview of the protective action of GSH against the exacerbated inflammation triggered by COVID-19 upon ACE/ACE2 imbalance was reported [12]. Additional evidence continued to suggest G6PD deficiency may not only play a role in COVID-19 susceptibility, but also severity of infection, therefore in order to answer this question, it would be Clinical perspective on the impact of coronavirus (COVID-19) pandemic on individuals with glucose -6phosphate dehydrogenase deficiency (G6PD)