Abstract
Background: A computational proteomic analysis suggested that SARS-CoV-2 might bind to hemoglobin (Hb). The authors hypothesized that this phenomenon could result in a decreased oxygen (O2) binding and lead to hemolytic anemia as well. The aim of this work was to investigate whether the affinity of Hb for O2 was altered during COVID-19.Methods: In this retrospective, observational, single-center study, the blood gas analyses of 100 COVID-19 patients were compared to those of 100 non-COVID-19 patients. Fifty-five patients with carboxyhemoglobin (HbCO) ≥8% and 30 with sickle cell disease (SCD) were also included (“positive controls” with abnormal Hb affinity). P50 was corrected for body temperature, pH, and PCO2.Results: Patients did not differ statistically for age or sex ratio in COVID-19 and non-COVID-19 groups. Median P50 at baseline was 26 mmHg [25.2–26.8] vs. 25.9 mmHg [24–27.3], respectively (p = 0.42). As expected, P50 was 22.5 mmHg [21.6–23.8] in the high HbCO group and 29.3 mmHg [27–31.5] in the SCD group (p < 0.0001). Whatever the disease severity, samples from COVID-19 to non-COVID-19 groups were distributed on the standard O2-Hb dissociation curve. When considering the time-course of P50 between days 1 and 18 in both groups, no significant difference was observed. Median Hb concentration at baseline was 14 g.dl–1 [12.6–15.2] in the COVID-19 group vs. 13.2 g.dl–1 [11.4–14.7] in the non-COVID-19 group (p = 0.006). Among the 24 COVID-19 patients displaying anemia, none of them exhibited obvious biological hemolysis.Conclusion: There was no biological argument to support the hypothesis that SARS-CoV-2 could alter O2 binding to Hb.
Highlights
In December 2019, a novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in the Chinese city of Wuhan
Samples from COVID-19 to non-COVID-19 groups were distributed on the standard O2-Hb dissociation curve
There was no biological argument to support the hypothesis that SARSCoV-2 could alter O2 binding to Hb
Summary
In December 2019, a novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in the Chinese city of Wuhan. The related coronavirus disease (COVID-19) rapidly spread worldwide during the following months, straining healthcare resources in many countries (Yu et al, 2020; Zhu et al, 2020) This pandemic urged the scientific community to quickly uncover and deliver information about the disease. The authors hypothesized that SARS-CoV-2 could dissociate iron ions from porphyrin, resulting in a decreased affinity of Hb for oxygen (O2) and a decrease in O2 binding. They speculated that this mechanism could lead to hemolytic anemia, and that some by-products could participate in the pathophysiology of the disease. The aim of this work was to investigate whether the affinity of Hb for O2 was altered during COVID-19
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