Glucose-6-Phosphate Dehydrogenase Deficiency: An Actionable Risk Factor for Patients with COVID-19?

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a common X-linked mutation that is more prevalent in African, Asian, Latin American and Mediterranean populations. Although most individuals are asymptomatic, exposure to certain food, drugs, or infections can trigger acute hemolytic anemia. Given the potential for coronavirus to trigger oxidative stress, unrecognized G6PD deficiency in the presence of the COVID-19 viral infection may cause hemolytic crisis and worse outcome in affected individuals. Further, since certain drugs that may be used to treat COVID-19 infection may cause hemolytic crisis in individuals with G6PD deficiency, it may be warranted to recommend adding G6PD deficiency to the list of screening elements in a COVID-19 workup for those patients where there is a high suspicion for this genetic mutation.

The use of ibuprofen to treat fever in COVID-19: A possible indirect association with worse outcome?

Fever has been reported as a common symptom occurring in COVID-19 illness. Over the counter antipyretics such as ibuprofen and acetaminophen are often taken by individuals to reduce the discomfort of fever. Recently, the safety of ibuprofen in COVID-19 patients has been questioned due to anecdotal reports of worsening symptoms in previously healthy young adults. Studies show that ibuprofen demonstrates superior efficacy in fever reduction compared to acetaminophen. As fever may have benefit in shortening the duration of viral illness, it is plausible to hypothesize that the antipyretic efficacy of ibuprofen may be hindering the benefits of a fever response when taken during the early stages of COVID-19 illness.