A Case Report of Methemoglobinemia and Hemolytic Anemia in the Setting of COVID-19 Pneumonia and G6PD Deficiency

It is well known that hereditary or acquired methemoglobinemia can cause hypoxia due to the oxidation of heme, which impairs its ability to offload oxygen (Figures 1 & 2), and that acquired methemoglobinemia is most often caused by exposure to drugs and toxins that oxidize hemoglobin to methemoglobin, directly or indirectly1. Recently, a few case reports have highlighted methemoglobinemia in patients with COVID-19 pneumonia. Some of these reports were due to treatment with hydroxychloroquine and others from unidentifiable causes2-4. We present a case in which a patient with COVID-19 pneumonia was diagnosed with methemoglobinemia and acute hemolysis from G6PD deficiency in the setting of worsening hypoxia after receiving treatment with dexamethasone, remdesivir, and high-dose vitamin C