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Sickle Cell Trait and the higher risk of death from COVID-19. It’s not what you think.

April 9, 2020 by DR. MYLAINE RIOBE
sickle cell COVID-19 and african americans-latinos

Statistics are beginning to show that African Americans and Latinos are being disproportionately impacted by COVID-19 coronavirus.  While the causes of this remain debatable, what isn’t debatable is that a significantly greater proportion of the African American community is dying of Coronavirus.  I believe the scientific community needs to take a close look at sickle cell trait and see if this is placing African Americans at higher risk.  It’s known that sickle cell trait confers protection against malaria, but could it be a risk factor for death from COVID-19?

Almost 10% of African Americans and 4-5% of Latinos have one gene mutation for sickle cell disease, which is a blood disorder affecting the hemoglobin molecules on the red blood cells which carry oxygen throughout the body.  When only one gene for sickle cell disease is present, we call this sickle cell trait.  It’s believed that this gene mutation occurred to protect against malaria, a potentially deadly blood infection caused by a parasite.  Sickle cell trait is not just isolated to African Americans and Latinos.  People of many different ethnicities can carry this mutation.  Approximately 1.5% of all babies born in the U.S. carry sickle cell trait. Although sickle cell trait is not considered a high-risk for COVID-19 complications, I believe it should be.

It was recently discovered that the new coronavirus, COVID-19, reproduces itself by breaking apart the hemoglobin in the red blood cells causing the cells to be incapable of carrying a sufficient amount of oxygen.  This leads to a slow suffocation of the cells of the body leading to shortness of breath and fatigue, as well as a massive inflammatory response as the body struggles to get the oxygen it needs to function.  This eventually leads to respiratory failure and multi-organ failure.

When COVID-19 cleaves the hemoglobin molecule, it releases iron into the blood stream leading to an iron overload which also causes significant fatigue and contributes to organ damage.  This produces a massive inflammatory reaction that leads to multiple organ failure.  The COVID-19 virus is believed to infect the body by binding to the ACE2 receptors on lung cells.  These lung cells are responsible for moistening the lungs and their damage leads to the dry cough many complain about.

It’s well known that those with sickle cell trait have microcirculatory problems that can lead to complications even though they don’t have the full disease itself.  According to the OMAN Medical Journal, those with sickle cell trait can have higher complications involving the lung, kidneys and spleen due to poor microcirculation.  They’re also more susceptible to sudden exercise-related death.

Having higher heme or hemoglobin can be like adding fuel to the fire for sickle cell trait patients and, in fact, many of the recognized “high-risk” categories have higher than normal heme or hemoglobin levels including diabetes, hypertension, and even male gender!  The heme theory would explain why children seem relatively spared as their hemoglobin levels are typically lower than the average adult.  Women also typically have lower hemoglobin levels than males, explaining the disparity in that demographic as well.

The fever is caused by the heat produced by the body’s response to infection.  If the infected person’s immunity is compromised, the virus has easier access to the tissues throughout the body and into the blood stream.  It can access hemoglobin to reproduce and releases iron in the process.  Excessive amounts of iron in the body can lead to inflammation and fibrosis (scarring) as is seen in COVID-19 patients.  This causes damage to the circulation of the lungs and other organs causing them to fail.  The consequences of iron overload are well known in the medical literature and it seems prudent to start checking iron levels in hospitalized patients to possibly remove this iron to keep the levels normal.  Iron can be removed from the body through the process of blood transfusion or chelation.  Chelation is a method by which a substance is introduced into the body that binds the metal you wish to remove.  In the case of iron, the chelating agent is called Desferal.  Chelation is often used for mercury or lead toxicity.  Chelation can also leach out our good minerals like magnesium, zinc, copper, selenium and more, so it’s important to reintroduce these into the body during chelation and monitor levels closely. Other natural chelating methods are used in the field of integrative medicine such as Chinese herbal therapies, chlorophyll and phytonutrients.

This iron accumulation can also be the cause of the massive inflammation seen in other high-risk COVID patients and may be something we need to look into and relieve in an effort to assist more patients in breathing off the ventilators.

A post-COVID syndrome is being identified as well.  It’s possible that the iron overload and inflammation caused by the virus may linger for some time and require attention along with the correction of the immune system failures that led to the primary infection.  This has not yet been borne out in studies, but based on what we already know, is a definite possibility.

Chloroquine is increasingly being thought to be an effective treatment based on anecdotal reports and also a bioinformatics report recently conducted in China.  Using computer models and the genetic code of the virus, engineers were able to predict which binding sites would work well with various agents and concluded that chloroquine and an anti-viral Favipiravir would be good candidates for success in stopping the virus COVID-19 from binding to hemoglobin. Please note that they did not indicate that HYDROXYCHLOROQUINE would be a good solution. Hydroxychloroquine has numerous side-effects and some medical studies on this drug had to be halted due to its toxicity. There’s a huge difference between chloroquine and hydroxychloroquine not appreciated by the medical community.  Natural chloroquine can can stop the virus from reproducing which would lead to viral death.

Chloroquine comes in a natural form called Qing Hao which has been used in Chinese medicine for thousands of years for the treatment of “heat diseases” and infections with little to no side effects.   Its active ingredient is called Artemisinin, which is a natural agent used for infections and cancer treatments by integrative medical doctors.  There are many medical studies supporting the use of artemisinin for viral infections with little to no side-effects.

Vitamin D and C as well as zinc are also being used to treat COVID-19 and can be a good addition to a preventive strategy.  Many hospitals are using high dose intravenous vitamin C along with zinc to help support immunity and combat the virus.  Vitamins C and zinc have long been known to kill viruses.

In order to protect our African-American and Latino communities, as well as others who may unknowingly be at high-risk, we should consider the social distancing recommendations, hand washing, masks and other CDC recommendations; however, consideration of sickle cell trait as a risk factor should be considered and even more aggressive measures taken to protect this vulnerable population with the addition of vitamins D, C, and zinc minerals.

Be safe during this tumultuous time.  Love, light and many blessings,

Dr. Mylaine Riobe, MD, FABOIM, FACOG

Director,

Riobe Institute of Integrative Medicine

(561) 244-5880

 

References:

  1. wenzhong, liu; hualan, Li (2020): COVID-19: Attacks the 1-Beta Chain of Hemoglobin and Captures the Porphyrin to Inhibit Human Heme Metabolism. ChemRxiv. Preprint. https://doi.org/10.26434/chemrxiv.11938173.v6
  2. Hemilä H. Vitamin C and Infections. Nutrients. 2017;9(4):339. Published 2017 Mar 29. doi:10.3390/nu9040339
  3. Wei Z, Burwinkel M, Palissa C, Ephraim E, Schmidt MF. Antiviral activity of zinc salts against transmissible gastroenteritis virus in vitro. Vet Microbiol. 2012;160(3-4):468–472. doi:10.1016/j.vetmic.2012.06.019
  4. Scott A Read, Stephanie Obeid, Chantelle Ahlenstiel, Golo Ahlenstiel, The Role of Zinc in Antiviral Immunity, Advances in Nutrition, Volume 10, Issue 4, July 2019, Pages 696–710, https://doi.org/10.1093/advances/nmz013
  5. Beard JA, Bearden A, Striker R. Vitamin D and the anti-viral state. J Clin Virol. 2011;50(3):194–200. doi:10.1016/j.jcv.2010.12.006
  6. John N. A review of clinical profile in sickle cell traits. Oman Med J. 2010;25(1):3–8. doi:10.5001/omj.2010.2
  7. Kohgo Y, Ikuta K, Ohtake T, Torimoto Y, Kato J. Body iron metabolism and pathophysiology of iron overload. Int J Hematol. 2008;88(1):7–15. doi:10.1007/s12185-008-0120-5
  8. Krishna S, Bustamante L, Haynes RK, Staines HM. Artemisinins: their growing importance in medicine. Trends Pharmacol Sci. 2008;29(10):520–527. doi:10.1016/j.tips.2008.07.004

 

 

 

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