Management of COVID-19 infection in organic acidemias

Am J Med Genet A. 2021 Jun;185(6):1854-1857. doi: 10.1002/ajmg.a.62161. Epub 2021 Mar 8.

Abstract

The COVID-19 pandemic has affected the health and healthcare of individuals of all ages worldwide. There have been multiple reports and reviews documenting a milder effect and decreased morbidity and mortality in the pediatric population, but there have only been a small number of reports discussing the SARS-CoV-2 infection in the setting of an inborn error of metabolism (IEM). Here, we report two patients with underlying metabolic disorders, propionic acidemia and glutaric aciduria type 1, and discuss their clinical presentation, as well as their infectious and metabolic management. Our report demonstrates that individuals with an underlying IEM are at risk of metabolic decompensation in the setting of a COVID-19 infection. The SARS-CoV-2 virus does not appear to cause a more severe metabolic deterioration than is typical.

Keywords: COVID-19; SARS-CoV-2; glutaric acidemia type 1; pediatric; propionic acidemia.

Publication types

  • Case Reports

MeSH terms

  • Acidosis / etiology
  • Acidosis / therapy
  • Acidosis, Lactic / etiology
  • Amino Acid Metabolism, Inborn Errors / complications*
  • Blood Component Transfusion
  • Brain Diseases, Metabolic / complications*
  • COVID-19 / complications*
  • COVID-19 / diagnosis
  • COVID-19 Nucleic Acid Testing
  • Combined Modality Therapy
  • Dietary Proteins / administration & dosage
  • Disease Management
  • Disease Susceptibility
  • Energy Intake
  • Enteral Nutrition
  • Female
  • Fluid Therapy
  • Glucose / administration & dosage
  • Glucose / adverse effects
  • Glutaryl-CoA Dehydrogenase / deficiency*
  • Humans
  • Hyperammonemia / etiology
  • Hyperammonemia / therapy
  • Hyperglycemia / chemically induced
  • Hyperglycemia / drug therapy
  • Infant
  • Insulin / therapeutic use
  • Intensive Care Units, Pediatric
  • Oxygen Inhalation Therapy
  • Pancytopenia / etiology
  • Pancytopenia / therapy
  • Propionic Acidemia / complications*
  • Renal Dialysis
  • SARS-CoV-2*
  • Systemic Inflammatory Response Syndrome / diagnosis

Substances

  • Dietary Proteins
  • Insulin
  • Glutaryl-CoA Dehydrogenase
  • Glucose

Supplementary concepts

  • Glutaric Acidemia I
  • pediatric multisystem inflammatory disease, COVID-19 related