Methemoglobinemia in COVID-19 Patients

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The authors report 3 cases of acquired methemoglobinemia occurring in COVID-19 patients treated with hydroxychloroquine. They describe the clinical presentations of the patients including persistently low oxygen concentrations despite mechanical ventilation with FIO2 of 100%, prompting evaluation with co-oximetry, and treatment with methylene blue and ascorbic acid. The authors suggest evaluating for G6PD deficiency prior to methylene blue administration as a cautionary measure, as the presence of G6PD deficiency can lead to the development of Coombs-negative hemolytic anemia.
The authors report methemoglobinemia associated with COVID-19 infection in patients treated with hydroxycholorquine and describe the approach to treatment and associated complications in such cases.