Antimalarial use in managing COVID-19 in the context of Glucose-6-Phosphate-Dehydrogenase G6PD deficiency

Ahmad Habeeb Hattab Dala Ali Alani, Noordin Othman, Sura Habeeb Hattab Al Ani

Abstract

Background
The use of certain medications in G6PD deficient patients can trigger an oxidative stress which can lead to haemolytic anaemia. Recently, in a few countries, Chloroquine and Hydroxychloroquine; drugs that are indicated for prevention and treating malaria have been used in the management of COVID-19 patients. Evidently, the use of chloroquine and hydroxychloroquine can cause negative impact to the haemolytic status of COVID-19 G6PD deficient patients.

Aims
The aim of this mini review was to provide an overview of the use of antimalarial agents in the management of COVID-19 G6PD deficient patients.

Methods
We conducted a review of the literature that has examined the use of antimalarial agents in the management of COVID-19 G6PD deficient patients.

Results
Chloroquine and hydroxychloroquine have been found to exhibits an antiviral activity against several viral infections including human coronaviruses. Many countries have implemented the use of Chloroquine and Hydroxychloroquine in managing COVID-19 patients. However, according to published case reports, the use of Chloroquine and hydroxychloroquine have been shown to worsen the haemolytic status in G6PD deficient patients.

Conclusion
COVID‐19 infection can trigger severe acute haemolytic crisis in G6PD‐deficient patients which can be worsened by chloroquine and hydroxychloroquine. Thus, physicians should be aware to this possible adverse event particularly in countries with high prevalence of G6PD deficiency.
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