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

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

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 partialand specific deffect in one of the enzymes of heme biosynthesis.There are eight different porphyrias, classified in cutaneous: PorphyriaCutanea Tarda (PCT), Erythropoietic Protoporphyria (EPP), Congenital Erythropoietic Porphyria (CEP) and HepatoerythropoieticPorphyria (HEP); acute: Acute Intermittent Porphyria (AIP) andNew Acute Porphyria (NPA) or mixed: Variegate Porphyria (VP) andHereditary Coproporphyria (HCP), according to symptoms. Somepapers in 2020 indicated that SARS-CoV-2 attacked β-hemoglobinchain releasing heme and producing protoporphyrin IX and Fe, favoringvirus infectivity by an interaction with the porphyrin. It wassuggested that hydroxychloroquine, used to mobilize and eliminateporphyrins, could be a suitable treatment. This hypothesis made usthink about how COVID-19 could affect porphyric patients who usuallyhave high content of porphyrins. Pandemic affected the amountof diagnosis during 2020, being diagnosed only 6 cases: 4 PCT,1EPP, 1 CEP. Until August 2021 we diagnosed: 22 PCT, 7 PAI, 2 VPand 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 significantlylow (64±9.6). Moreover, 29 patients had COVID-19: 20 AIP and 3PCT in spite of PCT is 10 times more frequent (PCT 1:20000, PAI1:215000). Two AIP patients were hospitalized and only one neededrespiratory assistance. Another AIP patient suffered an acute attacktwo months after COVID-19 positive. Heme parameters values weresimilar to that usually determined in these patients. This retrospectiveanalysis allows us to conclude that COVID-19 does not have adifferent expression than that of general population, no worseningrelated to the porphyric condition was observed. We consider thatan update of COVID-19 cases in porphyric patients would allow usto have more evidence about possible differences between acuteand cutaneous porphyrias.