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. 2024 Apr 9;110(6):1191-1197.
doi: 10.4269/ajtmh.23-0148. Print 2024 Jun 5.

Associations between COVID-19 and Glucose-6-Phosphate Dehydrogenase Activity in Brazil

Maria Gabriela de Almeida Rodrigues  1   2 , Wuelton Marcelo Monteiro  1   2 , Gisely Cardoso de Melo  1   2 , Ádila Liliane Barros Dias  1   2 , Marco Aurélio Sartim  3   4 , Mariana Simão Xavier  5 , Rebeca Linhares Abreu Netto  1   2 , Fernando Fonseca Almeida  1   2 , Djane Clarys Baía-da-Silva  1   2   3   4   6 , José Diego Brito-Sousa  1   2 , Marcus Vinicius Guimarães de Lacerda  1   2   6 , Vanderson de Souza Sampaio  2   7   8
Affiliations

Associations between COVID-19 and Glucose-6-Phosphate Dehydrogenase Activity in Brazil

Maria Gabriela de Almeida Rodrigues et al. Am J Trop Med Hyg. .

Abstract

Glucose-6 phosphate dehydrogenase deficiency (G6PDd) was suggested as a risk factor for severe disease in patients with COVID-19. We evaluated clinical outcomes and glucose-6 phosphate dehydrogenase (G6PD) activity during and after illness in patients with COVID-19. This prospective cohort study included adult participants (≥ 18 years old) who had clinical and/or radiological COVID-19 findings or positive reverse transcription-polymerase chain reaction results. Epidemiological and clinical data were extracted from electronic medical records. Glucose-6 phosphate dehydrogenase activity was measured using SD Biosensor STANDARD G6PD® equipment on admission and 1 year after discharge. Samples were genotyped for the three most common single nucleotide polymorphisms for G6PDd in the Brazilian Amazon. Seven hundred fifty-three patients were included, of whom 123 (16.3%) were G6PD deficient. There was no difference between groups regarding the risks of hospitalization (P = 0.740) or invasive mechanical ventilation (P = 0.31), but the risk of death was greater in patients with normal G6PD levels (P = 0.022). Only 29 of 116 participants (25%) carried the African G6PDd genotype. Of 30 participants tested as G6PD deficient during disease, only 11 (36.7%) results agreed 1 year after discharge. In conclusion, this study does not demonstrate an association of G6PDd with severity of COVID-19. Limitations of the test for detecting enzyme levels during COVID-19 illness were demonstrated by genotyping and retesting after the disease period. Care must be taken when screening for G6PDd in patients with acute COVID-19.

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Conflict of interest statement

Disclosure: We used data from the medical records of patients included in clinical trials conducted by the research team. These trials were approved by the Brazilian Committee of Ethics in Human Research for their respective original objectives (CAAE: 30152620.1.0000.0005, 30504220.5.0000.0005, and 30615920.2.0000.0005). All participants signed an informed consent form at the time of inclusion in the primary studies or, when unable, a family member performed the consent process. Participants’ sensitive data were made not available to avoid identification. All measures were taken to ensure participants’ confidentiality in accordance with good clinical practice.

Figures

Figure 1.
Figure 1.
Mean of the severity laboratory parameters evaluated: (A) hemoglobin, (B) C-reactive protein, (C) lymphocytes, (D) total bilirubin, (E) indirect bilirubin, (F) direct bilirubin, (G) alanine aminotransferase, (H) aspartate aminotransferase, (I) lactate dehydrogenase, (J) D-dimer. Groups were compared using the Wilcoxon rank-sum test, with ***P < 0.001 and **P < 0.05. G6PDd = glucose-6 phosphate dehydrogenase deficiency; G6PDn = normal glucose-6 phosphate dehydrogenase.
Figure 2.
Figure 2.
Glucose-6 phosphate dehydrogenase (G6PD) activity during and after COVID-19.
See this image and copyright information in PMC

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