Inborn errors of metabolism and COVID‐19: Evaluation of the metabolic outcome

Zubarioglu, Tanyel; Hopurcuoglu, Duhan; Ahmadzada, Saffa; Uzunyayla‐Inci, Gözde; Cansever, Mehmet Serif; Kiykim, Ertugrul; Aktuglu‐Zeybek, Cigdem

BACKGROUND: Infectious diseases can result a catabolic state and possibly trigger an acute metabolic decompensation in inborn errors of metabolism (IEM) that will even be life threatening. Studies regarding the course of SARS‐CoV‐2 infections in patients with IEM are generally limited to case reports. Here, we aimed to evaluate the clinical findings of COVID‐19 and describe the impact of SARS‐CoV‐2 infections on metabolic outcome in IEM patients. METHODS: Patients who were diagnosed as different types of IEM and developed microbiologically confirmed COVID‐19 infection were included. Clinical findings and laboratory results were recorded retrospectively in terms of both IEM and COVID‐19. RESULTS: Eleven patients with diagnosis of intoxication type metabolic disorders, five patients with energy metabolism disorders and six patients with complex molecular disorders were enrolled. The most frequent clinical finding was fever (52.1%) followed by fatigue/myalgia (47.8%). None of the patients was younger than 1 years of old. None of the patients presented severe or critical disease. In terms of metabolic decompensation, two patients diagnosed with propionic acidemia, one patient with methylmalonic acidemia and one patient with 3‐hydroxy‐3‐methylglutaryl‐CoA lyase deficiency presented clinical and biochemical findings of an acute metabolic attack. CONCLUSIONS: Based on our results, IEM are not found to be an additional risk factor for severe COVID‐19 infection. However, patients with ‐ particularly intoxication type and energy metabolism disorders‐should be considered as a vulnerable population for COVID‐19 and have a major risk of developing acute metabolic decompensation that can lead to life threatening complications.