Preliminary communication

https://doi.org/10.20471/acc.2020.59.04.21

Could COVID-19 Be a Hemoglobinopathy?

Tania Ahmed Shakoori ; Institute of Molecular Biology and Biotechnology (IMBB), University of Lahore, New Campus, Defense Road 1, KM off Raiwind Road, Lahore, Pakistan
Muhammad Mansoor Hafeez ; Institute of Molecular Biology and Biotechnology (IMBB), University of Lahore, New Campus, Defense Road 1, KM off Raiwind Road, Lahore, Pakistan
Arif Malik ; Institute of Molecular Biology and Biotechnology (IMBB), University of Lahore, New Campus, Defense Road 1, KM off Raiwind Road, Lahore, Pakistan

Abstract

The world is struggling to deal with the corona pandemic. Effective therapies are
still awaited due to the lack of understanding of the pathophysiological mechanism of the disease.
Bearing recent research and clinical observations in mind, the authors propose a novel physiological
mechanism of COVID-19 and explain development of COVID-19 related acute respiratory distress
syndrome (ARDS) secondary to COVID-19 related hemoglobinopathy. It is a consistent observation
that the radiological picture of COVID-19 related ARDS bears more resemblance to high altitude
pulmonary edema (HAPE) than typical ARDS. There has been great controversy regarding this proposed
similarity. The main argument from those objecting to this comparison is that the etiology is
hypoxia in case of HAPE and inflammation in COVID-19 related ARDS. We propose that considering
the recent bioinformatics prediction models, COVID-19 might first infect red blood cells via
CD147 and cause hemoglobin damage. The resulting hypoxemia may cause pulmonary hypoxic vasoconstriction
leading to HAPE-like lung lesions. The now introduced alveolar hypoxia further exaggerates
hemoglobinopathy hypoxemia leading to a vicious cycle. In this review, the authors recommend
laboratory experiments to prove these hypotheses. The proposed physiological mechanism has significant
therapeutic implications. If proven, the authors suggest the use of exchange transfusion as adjunct
therapy and development of anti-CD147 drugs.

Keywords

COVID-19; High altitude pulmonary embolism; High altitude pulmonary edema, pathophysiology; Acute respiratory distress syndrome; CD147

Hrčak ID:

254900

URI

https://hrcak.srce.hr/254900

Publication date:

1.12.2020.

Article data in other languages: croatian

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