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Associations between COVID-19 and Glucose-6-Phosphate Dehydrogenase Activity in Brazil
Maria Gabriela de Almeida Rodrigues
Maria Gabriela de Almeida Rodrigues
Universidade do Estado do Amazonas, Manaus, Brazil;
Department of Education and Research, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil;
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Department of Education and Research, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil;
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Wuelton Marcelo Monteiro
Wuelton Marcelo Monteiro
Universidade do Estado do Amazonas, Manaus, Brazil;
Department of Education and Research, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil;
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Department of Education and Research, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil;
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Gisely Cardoso de Melo
Gisely Cardoso de Melo
Universidade do Estado do Amazonas, Manaus, Brazil;
Department of Education and Research, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil;
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Department of Education and Research, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil;
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Ádila Liliane Barros Dias
Ádila Liliane Barros Dias
Universidade do Estado do Amazonas, Manaus, Brazil;
Department of Education and Research, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil;
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Department of Education and Research, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil;
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Marco Aurélio Sartim
Marco Aurélio Sartim
Department of Postgraduate, Research and Innovation, Universidade Nilton Lins, Manaus, Brazil;
Institute of Biological Sciences, Universidade Federal do Amazonas, Manaus, Brazil;
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Institute of Biological Sciences, Universidade Federal do Amazonas, Manaus, Brazil;
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Mariana Simão Xavier
Mariana Simão Xavier
Clinical Research Laboratory for Acute Febrile Illnesses, Instituto Nacional de Infectologia Carlos Chagas, Rio de Janeiro, Brazil;
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Rebeca Linhares Abreu Netto
Rebeca Linhares Abreu Netto
Universidade do Estado do Amazonas, Manaus, Brazil;
Department of Education and Research, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil;
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Department of Education and Research, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil;
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Fernando Fonseca Almeida
Fernando Fonseca Almeida
Universidade do Estado do Amazonas, Manaus, Brazil;
Department of Education and Research, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil;
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Department of Education and Research, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil;
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Djane Clarys Baía-da-Silva
Djane Clarys Baía-da-Silva
Universidade do Estado do Amazonas, Manaus, Brazil;
Department of Education and Research, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil;
Department of Postgraduate, Research and Innovation, Universidade Nilton Lins, Manaus, Brazil;
Institute of Biological Sciences, Universidade Federal do Amazonas, Manaus, Brazil;
Instituto Leônidas e Maria Deane/Fiocruz Amazônia, Instituto de Pesquisas Clínicas Carlos Borborema, Manaus, Brazil;
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Department of Education and Research, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil;
Department of Postgraduate, Research and Innovation, Universidade Nilton Lins, Manaus, Brazil;
Institute of Biological Sciences, Universidade Federal do Amazonas, Manaus, Brazil;
Instituto Leônidas e Maria Deane/Fiocruz Amazônia, Instituto de Pesquisas Clínicas Carlos Borborema, Manaus, Brazil;
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José Diego Brito-Sousa
José Diego Brito-Sousa
Universidade do Estado do Amazonas, Manaus, Brazil;
Department of Education and Research, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil;
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Department of Education and Research, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil;
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Marcus Vinicius Guimarães de Lacerda
Marcus Vinicius Guimarães de Lacerda
Universidade do Estado do Amazonas, Manaus, Brazil;
Department of Education and Research, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil;
Instituto Leônidas e Maria Deane/Fiocruz Amazônia, Instituto de Pesquisas Clínicas Carlos Borborema, Manaus, Brazil;
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Department of Education and Research, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil;
Instituto Leônidas e Maria Deane/Fiocruz Amazônia, Instituto de Pesquisas Clínicas Carlos Borborema, Manaus, Brazil;
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Vanderson de Souza Sampaio
Vanderson de Souza Sampaio
Department of Education and Research, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil;
Fundação de Vigilância em Saúde do Amazonas, Manaus, Brazil;
Instituto Todos pela Saúde, São Paulo, Brazil
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Fundação de Vigilância em Saúde do Amazonas, Manaus, Brazil;
Instituto Todos pela Saúde, São Paulo, Brazil
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ABSTRACT.
Glucose-6 phosphate dehydrogenase deficiency (G6PDd) was suggested as a risk factor for severe disease in patients with COVID-19. We evaluated clinical outcomes and glucose-6 phosphate dehydrogenase (G6PD) activity during and after illness in patients with COVID-19. This prospective cohort study included adult participants (≥ 18 years old) who had clinical and/or radiological COVID-19 findings or positive reverse transcription–polymerase chain reaction results. Epidemiological and clinical data were extracted from electronic medical records. Glucose-6 phosphate dehydrogenase activity was measured using SD Biosensor STANDARD G6PD® equipment on admission and 1 year after discharge. Samples were genotyped for the three most common single nucleotide polymorphisms for G6PDd in the Brazilian Amazon. Seven hundred fifty-three patients were included, of whom 123 (16.3%) were G6PD deficient. There was no difference between groups regarding the risks of hospitalization (P = 0.740) or invasive mechanical ventilation (P = 0.31), but the risk of death was greater in patients with normal G6PD levels (P = 0.022). Only 29 of 116 participants (25%) carried the African G6PDd genotype. Of 30 participants tested as G6PD deficient during disease, only 11 (36.7%) results agreed 1 year after discharge. In conclusion, this study does not demonstrate an association of G6PDd with severity of COVID-19. Limitations of the test for detecting enzyme levels during COVID-19 illness were demonstrated by genotyping and retesting after the disease period. Care must be taken when screening for G6PDd in patients with acute COVID-19.
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Author Notes
Financial support: This work was supported by
Disclosure: We used data from the medical records of patients included in clinical trials conducted by the research team. These trials were approved by the Brazilian Committee of Ethics in Human Research for their respective original objectives (CAAE: 30152620.1.0000.0005, 30504220.5.0000.0005, and 30615920.2.0000.0005). All participants signed an informed consent form at the time of inclusion in the primary studies or, when unable, a family member performed the consent process. Participants’ sensitive data were made not available to avoid identification. All measures were taken to ensure participants’ confidentiality in accordance with good clinical practice.
Authors’ addresses: Maria Gabriela de Almeida Rodrigues, Wuelton Marcelo Monteiro, Gisely Cardoso de Melo, Ádila Liliane Barros Dias, Rebeca Linhares Abreu Netto, Fernando Fonseca Almeida, and José Diego Brito-Sousa, Universidade do Estado do Amazonas, Manaus, Brazil, and Department of Education and Research, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil, E-mails: rodriguesgabriela016@gmail.com, wueltonmm@gmail.com, cardosogisely@gmail.com, adiladias@yahoo.com.br, rbk.netto@gmail.com, ffaval@gmail.com, and sousajdb@live.com. Marco Aurélio Sartim, Department of Postgraduate, Research and Innovation, Universidade Nilton Lins, Manaus, Brazil, and Institute of Biological Sciences, Universidade Federal do Amazonas, Manaus, Brazil, E-mail: marcosartim@hotmail.com. Mariana Simão Xavier, Clinical Research Laboratory for Acute Febrile Illnesses, Instituto Nacional de Infectologia Carlos Chagas, Rio de Janeiro, Brazil, E-mail: marianasimaoxavier@gmail.com. Djane Clarys Baía-da-Silva, Universidade do Estado do Amazonas, Manaus, Brazil, Department of Education and Research, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil, Department of Postgraduate, Research and Innovation, Universidade Nilton Lins, Manaus, Brazil, Institute of Biological Sciences, Universidade Federal do Amazonas, Manaus, Brazil, and Instituto Leônidas e Maria Deane/Fiocruz Amazônia, Manaus, Brazil, E-mail: djane.claryss@gmail.com. Marcus Vinicius Guimarães de Lacerda, Universidade do Estado do Amazonas, Manaus, Brazil, Department of Education and Research, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil, and Instituto Leônidas e Maria Deane/Fiocruz Amazônia, Manaus, Brazil, E-mail: marcuslacerda.br@gmail.com. Vanderson de Souza Sampaio, Department of Education and Research, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil, Fundação de Vigilância em Saúde do Amazonas, Manaus, Brazil, and Instituto Todos pela Saúde, São Paulo, Brazil, E-mail: vandersons@gmail.com.
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