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

MELITO, V; GOÑI, V; CABALLERO, A; GUOLO, M; WINITZKY, P; VARELA L.S.; NORIEGUA, G; MURAMATSU, H; TOMASSI, L.; BUZALEH A.M.; ROSSETTI MV; PARERA, V

MEDICINA (BUENOS AIRES)

MEDICINA (BUENOS AIRES)

Lugar: Buenos Aires; Año: 2021 vol. 81 p. 176 - 176

0025-7680

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 AIP, 2 VP and 1 EPP. The comparison with the median of cases of the last 10 years showed similar values for AIP (4.5±2.2) but significantly lower for PCT (64±9.6). During pandemic 43 patients had COVID-19: 28 AIP, 6 PCT, 5 VP 1 HCP, 3 EPP. Two AIP patients were hospitalized. An AIP patient suffered an acute attack two months after COVID-19 and another got it in hospital during a crisis. Heme parameters were similar to those usually determined in 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. PCT is 10 times more frequent than AIP (1:20000 vs 1:215000) however a higher amount of COVID-19 was found in AIP. An update of COVID-19 cases in porphyric patients would allow to have more evidence of possible differences in getting infected.