Dear Editor,
We would like to share ideas on the publication “Hemoglobinopathy and pediatrics in the time of COVID-19.11 Vilela TS, Braga JAP, Loggetto SR. Hemoglobinopathy and pediatrics in the time of COVID-19. Hematol Transfus Cell Ther. 2021;43(1):87–100.” Vilela et al. concluded that, “Despite pediatric population with SCD needs more intensive care, the outcome after infection by COVID-19 is favorable.11 Vilela TS, Braga JAP, Loggetto SR. Hemoglobinopathy and pediatrics in the time of COVID-19. Hematol Transfus Cell Ther. 2021;43(1):87–100.” A previous report from Iran noted that patients with thalassemia/hemoglobinopathy had a possible susceptible nature to severe COVID-19.22 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. However, a report from Southeast Asia showed an opposite conclusion.33 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. 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-19.44 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. Pharmacologically, the iron chelating agent can suppress endothelial inflammation, which is the main pathophysiologic mechanism in COVID-19.44 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.
REFERENCES
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1Vilela TS, Braga JAP, Loggetto SR. Hemoglobinopathy and pediatrics in the time of COVID-19. Hematol Transfus Cell Ther. 2021;43(1):87–100.
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2Karimi 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.
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3Papadopoulos 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.
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4Dalamaga 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
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Publication in this collection
18 Oct 2021 -
Date of issue
Jul-Sep 2021
History
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Received
19 Mar 2021 -
Accepted
14 Apr 2021 -
Published
18 May 2021