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The Role of Methemoglobin and Carboxyhemoglobin in COVID-19: A Review

1
Biomedical Optics Research Laboratory, Department of Neonatology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland
2
Newborn Research Zurich, Department of Neonatology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland
3
Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2021, 10(1), 50; https://doi.org/10.3390/jcm10010050
Received: 9 November 2020 / Revised: 15 December 2020 / Accepted: 22 December 2020 / Published: 25 December 2020
(This article belongs to the Section Infectious Diseases)
Following the outbreak of a novel coronavirus (SARS-CoV-2) associated with pneumonia in China (Corona Virus Disease 2019, COVID-19) at the end of 2019, the world is currently facing a global pandemic of infections with SARS-CoV-2 and cases of COVID-19. Since severely ill patients often show elevated methemoglobin (MetHb) and carboxyhemoglobin (COHb) concentrations in their blood as a marker of disease severity, we aimed to summarize the currently available published study results (case reports and cross-sectional studies) on MetHb and COHb concentrations in the blood of COVID-19 patients. To this end, a systematic literature research was performed. For the case of MetHb, seven publications were identified (five case reports and two cross-sectional studies), and for the case of COHb, three studies were found (two cross-sectional studies and one case report). The findings reported in the publications show that an increase in MetHb and COHb can happen in COVID-19 patients, especially in critically ill ones, and that MetHb and COHb can increase to dangerously high levels during the course of the disease in some patients. The medications given to the patient and the patient’s glucose-6-phospate dehydrogenase (G6PD) status seem to be important factors determining the severity of the methemoglobinemia and carboxyhemoglobinemia. Therefore, G6PD status should be determined before medications such as hydroxychloroquine are administered. In conclusion, MetHb and COHb can be elevated in COVID-19 patients and should be checked routinely in order to provide adequate medical treatment as well as to avoid misinterpretation of fingertip pulse oximetry readings, which can be inaccurate and unreliable in case of elevated MetHb and COHb levels in the blood. View Full-Text
Keywords: COVID-19; SARS-CoV-2; methemoglobin; methemoglobinemia; carboxyhemoglobin; carboxyhemoglobinemia COVID-19; SARS-CoV-2; methemoglobin; methemoglobinemia; carboxyhemoglobin; carboxyhemoglobinemia
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MDPI and ACS Style

Scholkmann, F.; Restin, T.; Ferrari, M.; Quaresima, V. The Role of Methemoglobin and Carboxyhemoglobin in COVID-19: A Review. J. Clin. Med. 2021, 10, 50. https://doi.org/10.3390/jcm10010050

AMA Style

Scholkmann F, Restin T, Ferrari M, Quaresima V. The Role of Methemoglobin and Carboxyhemoglobin in COVID-19: A Review. Journal of Clinical Medicine. 2021; 10(1):50. https://doi.org/10.3390/jcm10010050

Chicago/Turabian Style

Scholkmann, Felix; Restin, Tanja; Ferrari, Marco; Quaresima, Valentina. 2021. "The Role of Methemoglobin and Carboxyhemoglobin in COVID-19: A Review" J. Clin. Med. 10, no. 1: 50. https://doi.org/10.3390/jcm10010050

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