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Table of Contents
ORIGINAL ARTICLE
Year : 2022  |  Volume : 1  |  Issue : 4  |  Page : 252-254

Association between alpha-thalassemia carrier prevalence and incidence of COVID-19


1 Private Academi Consultant, Bangkok, Thailand
2 Department of Biological Science, Joseph Ayobabalola University, Ikeji-Arakeji, Osun, Nigeria

Date of Submission16-Aug-2022
Date of Decision25-Sep-2022
Date of Acceptance10-Oct-2022
Date of Web Publication5-Dec-2022

Correspondence Address:
Pathum Sookaromdee
Private Academi Consultant, 111 Bangkok 122 Bangkok 103300
Thailand
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jpdtsm.jpdtsm_74_22

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  Abstract 


BACKGROUND: The association between COVID-19 incidence and genetic underlying is an interesting issue. The possible association between thalassemia and COVID-19 is proposed. In additional to beta-thalassemia, alpha-thalassemia is another important group of thalassemic disorder.
MATERIALS AND METHODS: In this report, the authors present an observation on correlation between alpha-thalassemia 1carrier prevalence and incidence of COVID-19 from a tropical country in Southeast Asia that alpha-thalassemia is endemic.
RESULTS: According to this study, there is no significant correlation and the calculated correlation coefficient between alpha-thalassemia carrier prevalence and incidence of COVID-19 is equal to − 0.82 (P > 0.05).
CONCLUSION: According to the current data, there is no discernible link between the incidence of COVID-19 and the prevalence of alpha-thalassemia 1 carriers.

Keywords: Alpha-thalassemia 1, correlation, COVID-19


How to cite this article:
Sookaromdee P, Wiwanitkit V. Association between alpha-thalassemia carrier prevalence and incidence of COVID-19. J Prev Diagn Treat Strategies Med 2022;1:252-4

How to cite this URL:
Sookaromdee P, Wiwanitkit V. Association between alpha-thalassemia carrier prevalence and incidence of COVID-19. J Prev Diagn Treat Strategies Med [serial online] 2022 [cited 2023 Jan 29];1:252-4. Available from: http://www.jpdtsm.com/text.asp?2022/1/4/252/362826




  Introduction Top


COVID-19 is an important infection affecting more than 145 million people. The association between COVID-19 incidence and genetic underlying is an interesting issue. The possible association between thalassemia and COVID-19 is proposed.[1],[2] It is observed that there might be a natural resistance of cases with beta-thalassemia against COVID-19.[1],[2] In additional to beta-thalassemia, alpha-thalassemia is another important group of thalassemic disorder.

In this report, the authors present an observation on correlation between alpha-thalassemia 1carrier prevalence and incidence of COVID-19 from a tropical country in Southeast Asia that alpha-thalassemia is endemic. In the study setting, Indochina, there is a very high incidence of thalassemia. The locals from this region have high rates of hemoglobin E, alpha-and beta-thalassemia diseases, and glucose-6-phosphate dehydrogenase deficiency.[3] The local incidence of alpha-thalassemia gene carrier is about 15%–30% of local people.[4],[5] The local epidemiology data shows that there is an extremely high incidence on thalassemia comparing to other areas of the world.[4] An explanation is the long term genetic adaptation to the local high incidence of malaria.[6]


  Materials and Methods Top


The present study is a clinical mathematical correlation study. The aim is to determine association between alpha-thalassemia 1 carrier prevalence and incidence of COVID-19. The primary data from previous publication on alpha-thalassemia 1 carrier prevalence are used.[7] For data on incidence of COVID-19, public data from Ministry of Public Health (https://covid19.ddc.moph.go.th/) are used.

To assess association, the correlation between alpha-thalassemia 1 carrier prevalence and incidence of COVID-19 in different health regions is calculated. Since the present study is not a study on human or animal subjects, it requires no ethical approval or informed consent.


  Results Top


Primary data are presented in [Table 1]. There is no significant correlation and the calculated correlation coefficient between alpha-thalassemia carrier prevalence and incidence of COVID-19 is equal to − 0.82 (P > 0.05).
Table 1: The correlation between alpha-thalassemia 1 carrier prevalence and incidence of COVID-19 in different region

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  Discussion Top


One of the most prevalent and significant inherited red blood cell disorders is thalassemia. The prevalence of the illness is really high in our region. Millions of residents were already infected with COVID-19 when the disease first spread to Southeast Asia during the COVID-19 era. It is conceivable for COVID-19 and thalassemia to co-infect. Approximately one-third of all COVID-19 cases in the region with a high incidence of thalassemia also have hemoglobin disorder.[8]

The interrelationship between underlying alpha-thalassemia and COVID-19 is an interesting issue for investigation. For a case with underlying thalassemic disorder, an increased severity of COVID-19 is an issued to be studied. There is a report confirming that there might be coagulation abnormalities due to COVID-19 in a child with thalassemia.[9] Enhanced mortality of-thalassemia heterozygotes from COVID-19 is indicated by a pilot study by Sotiriou et al.[10] On the other hand, the immunopathological process of COVID-19 in a thalassemia case might also be altered. Lansiaux et al. recently reported that immunity against COVID-19 might be clinically related beta-thalassemic heterozygote population prevalence.[1] Resistance to COVID-19 attack might be resulted from abnormal globin chain in hemoglobin in thalassemic patients.[1],[2] In order to cause an ACE/ACE2 imbalance and promote erythropoietin EPO hypersecretion utilizing tissue RAS, uncoupled from hemoglobin levels, the SARS-CoV-2 coronavirus must enter the cell.[11] As their EPO stimulation is decoupled from the RAS system, thalassemia carriers would benefit from protection at any age.[11]

In this work, the authors add an observation from the previous studies on beta-thalassemia. The study on alpha-thalassemia is done. Analysis on the clinical association of alpha-thalassemia is done and reported. Of interest, the present study shows an observation that is discordant with the previous reports on beta-thalassemia,[1],[2] no resistant nature of alpha-thalassemia 1 carrier to COVID-19. In fact, the earlier publication stated that if infected with COVID-19, a case with an underlying alpha-thalassemia condition could easily evolve into a severe clinical problem.[12] As a result, the actual COVID-19 data in the thalassemia situation may not agree with previously offered hypothetical solutions.[2],[11] In fact, a recent study from Italy, where thalassemia is also extremely prevalent, demonstrated that people with underlying hereditary red blood cell problems, such as thalassemia, are susceptible to developing serious illness. In individuals with an underlying hemoglobin disease, the first asymptomatic COVID-19 instance developed serious clinical issues and required hospitalization.[12] The lack of a link in our study may indicate that there are numerous confounding factors that can alter how SARS-CoV-2 infection manifests in a patient with underlying thalassemia even while there is no direct correlation between the two.

The epidemiology of COVID-19 is distinct and influenced by a variety of factors.[13] The situation changes with time, and it is important to remember the impact local disease control measures have.[13] The concomitant medical condition could impact inflammatory pathways or other pathophysiology aspects of COVID-19.[14],[15] In addition, the pattern of COVID-19 may be impacted by personal medication.[16] The exact interrelationship between thalassemia and COVID-19 is an interesting issue for further studies in clinical hematology. Furthermore, further studies on other common genetic hematological disorders such as hemoglobinopathies are recommended.


  Conclusion Top


Based on the present analysis, no significant correlation between alpha-thalassemia 1 carrier prevalence and incidence of COVID-19 is observed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Lansiaux E, Pébaÿ PP, Picard JL, Son-Forget J. COVID-19: Beta-thalassemia subjects immunised? Med Hypotheses 2020;142:109827.  Back to cited text no. 1
    
2.
Drouin E. Beta-thalassemia may protect against COVID 19. Med Hypotheses 2020;143:110014.  Back to cited text no. 2
    
3.
Monzon CM, Fairbanks VF, Burgert EO Jr, Sutherland JE, Elliot SC. Hematologic genetic disorders among Southeast Asian refugees. Am J Hematol 1985;19:27-36.  Back to cited text no. 3
    
4.
Winichagoon P, Thonglairuam V, Fucharoen S, Tanphaichito VS, Wasi P. Alpha-thalassemia in Thailand. Hemoglobin 1988;12:485-98.  Back to cited text no. 4
    
5.
Prevention and control of thalassemia in obstetric practice. Srinagarind Med J 2007;22:471-6.  Back to cited text no. 5
    
6.
Kariuki SN, Williams TN. Human genetics and malaria resistance. Hum Genet 2020;139:801-11.  Back to cited text no. 6
    
7.
Tienthavorn V, Pattanapongsthorn J, Charoensak S, Sae-Tung R, CharoenkwanP, Sanguansermsri T. Prevalence of thalassemia carriers in Thailand. Thai J Hematol Transf Med 2006;16:307-12.  Back to cited text no. 7
    
8.
Papadopoulos KI, Sutheesophon W, Manipalviratn S, Aw TC. A Southeast Asian perspective on the COVID-19 pandemic: Hemoglobin E (HbE)-Trait confers resistance against COVID-19. Med Sci Monit Basic Res 2021;27:e929207.  Back to cited text no. 8
    
9.
Mungmunpuntipantip R, Wiwanitkit V. Coagulation abnormalities Due to COVID-19 in a Child with thalassemia: Correspondence. Indian J Pediatr 2021;88:736.  Back to cited text no. 9
    
10.
Sotiriou S, Samara AA, Vamvakopoulou D, Vamvakopoulos KO, Sidiropoulos A, Vamvakopoulos N, et al. Susceptibility of β-Thalassemia heterozygotes to COVID-19. J Clin Med 2021;10:3645.  Back to cited text no. 10
    
11.
Motelow JE, Kahn S, Wilson PT. COVID-19 mortality in a pediatric patient with hemoglobin SC disease and Alpha-Thalassemia trait. Case Rep Crit Care 2021;2021:6617362.  Back to cited text no. 11
    
12.
de Sanctis V, Canatan D, Corrons JL, Karimi M, Daar S, Kattamis C, et al. Preliminary data on COVID-19 in patients with hemoglobinopathies: A multicentre ICET-A study. Mediterr J Hematol Infect Dis 2020;12:e2020046.  Back to cited text no. 12
    
13.
Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: A descriptive study. Lancet 2020;395:507-13.  Back to cited text no. 13
    
14.
Ali Saad K, Younus Jasim A. Serum levels of interleukin 6, ferritin, C reactive protein, lactate dehydrogenase, D dimer, and count of lymphocytes and neutrophils in COVID 19 patients: Its correlation to the disease severity. Biomed Biotechnol Res J 2021;5:69.  Back to cited text no. 14
    
15.
Al-Muhana IR, Ahmed MM, Al-Muhana IR, AL-Hasan BA. Impact of proinflammatory cytokines: (Interleukin 6, Interleukin 1α, and Interleukin 1β) on biochemical parameters in severe acute respiratory syndrome coronavirus 2 patients in Iraq. Biomed Biotechnol Res J 2022;6:170-4  Back to cited text no. 15
    
16.
Verma T, Sinha M, Bansal N, Yadav SR, Shah K, Chauhan NS. A review on coronavirus disease and potentially active drugs targeting coronavirus. Biomed Biotechnol Res J 2021;5:110.  Back to cited text no. 16
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