PORPHYRIAS DURING SARS-CoV-2 PANDEMIC. A RETROSPECTIVE ANALYSIS

GOÑI, VERONICA; WINITZKY, PABLO; MURAMATSU, HECTOR; MELITO, VIVIANA; GUOLO, MARCELO; NORIEGA, GUILLERMO; PARERA VICTORIA; CABALLERO, ALEJANDRA; VARELA, LAURA; BUZALEH ANA MARIA

Virtual

Congreso; LXVI REUNIÓN ANUAL DE LA SOCIEDAD ARGENTINA DE INVESTIGACIÓN CLÍNICA (SAIC); 2021

Sociedad Argentina de Investigación Clínica

Porphyrias are a group of metabolic diseases produced by partial and specific deffect in one of the enzymes of heme biosynthesis.There are eight different porphyrias, classified in cutaneous: Porphyria Cutanea Tarda (PCT), Erythropoietic Protoporphyria (EPP), Congenital Erythropoietic Porphyria (CEP) and Hepatoerythropoietic Porphyria (HEP); acute: Acute Intermittent Porphyria (AIP) and New Acute Porphyria (NPA) or mixed: Variegate Porphyria (VP) and Hereditary Coproporphyria (HCP), according to symptoms. Some papers in 2020 indicated that SARS-CoV-2 attacked β-hemoglobin chain releasing heme and producing protoporphyrin IX and Fe, favoring virus infectivity by an interaction with the porphyrin. It was suggested that hydroxychloroquine, used to mobilize and eliminate porphyrins, could be a suitable treatment. This hypothesis made us think about how COVID-19 could affect porphyric patients who usually have high content of porphyrins. Pandemic affected the amount of diagnosis during 2020, being diagnosed only 6 cases: 4 PCT, 1EPP, 1 CEP. Until August 2021 we diagnosed: 22 PCT, 7 PAI, 2 VP and 1 EPP. A review of last 10 years showed that AIP cases in 2021, were about the median value (4.5±2.2) while PCT were significantly low (64±9.6). Moreover, 29 patients had COVID-19: 20 AIP and 3 PCT in spite of PCT is 10 times more frequent (PCT 1:20000, PAI 1:215000). Two AIP patients were hospitalized and only one needed respiratory assistance. Another AIP patient suffered an acute attack two months after COVID-19 positive. Heme parameters values were similar to that usually determined in these patients. This retrospective analysis allows us to conclude that COVID-19 does not have a different expression than that of general population, no worsening related to the porphyric condition was observed. We consider that an update of COVID-19 cases in porphyric patients would allow us to have more evidence about possible differences between acute and cutaneous porphyrias.