SARS-CoV-2, hemoglobin and protoporphyrin IX: Interactions and perspectives

Abstract

Background SARS-CoV-2 attacks hemoglobin through its structural protein ORF3a, dissociating the iron from the heme, as iron is necessary by cell machinery for virus replication. In this process protoporphyrin (PpIX) is released. Methods The decrease in the hemoglobin levels observed in patients with Covid-19 is frequently accompanied by an increase in PpIX levels. This evidence was confirmed by the quantification of PpIX by high-performance liquid chromatography (HPLC). PpIX emission is observed in its two characteristic bands at approximately 635 nm and 705 nm. Results This paper searches to understand the role of heme and PpIX inside the cells. Perspectives on the use of PpIX fluorescence as a sensor to monitor the presence of SARS-CoV-2 in the tissue, blood, urine, or feces to map the evolution and severity of the disease or to monitor the response of the Covid-19 treatment modalities were described. Conclusion Fluorescence spectroscopy could be adopted as an excellent diagnostic technique for Covid-19, of low cost and high sensitivity. This method can potentially be used as a marker to monitor the response to the treatments. Photodynamic and sonodynamic therapies using the endogenous PpIX increased in the acute phase of the disease, could be employed for Covid-19 treatment.

Development of a multiomics model for identification of predictive biomarkers for COVID-19 severity: a retrospective cohort study

“…High concentrations of heme in patients admitted to hospital is consistent with reports that SARS-CoV-2 causes elevation of free heme. 29 TMAP, a marker of reduced kidney function, showed a positive association with increasing severity, which supports findings from a 2021 study that reported the same trend in patients with severe disease. 30 Polyamines facilitate virus replication by aiding cellular attachment; the increased polyamine concentrations in hospitalised patients might indicate increased disease severity.…”

Can iron, zinc, copper and selenium status be a prognostic determinant in COVID-19 patients?

“…ORF3a has heme-Fe binding sites and degrades trapped heme into Fe and porphyrin. In that case, even if hemoglobin preserves its native structure, its oxygen delivery function is decreased ( Courrol et al, 2021 , Liu and Li, 2022 , Redondo et al, 2021 ). Furthermore, in COVID-19 patients, SARS-CoV-2 may cause decomposition of the hemoglobin.…”

Protoporphyrin IX: An Endogenous Theranostic Compound

“…The analysis of the intrinsic PpIX fluorescence from blood, urine, and feces samples can yield information on the presence of SARS-Cov-2 in the body [28].…”