6851 The role of health literacy in preventing adverse reactions in G6PD deficient people around COVID and other comorbidities

Objectives Glucose-6-phosphate dehydrogenase (G6PD), or the 'housekeeping enzyme', guards against oxidative stress (i.e., the build-up of damaging free radicals, typical metabolic by-products) and the harm caused to the red blood cells (RBCs). G6PD deficiency (G6PDD) causes rapid RBC destruction faster than their replenishment, resulting in haemolytic anaemia. 4.9% of the world's population is afflicted with G6PDD, typically males and is prevalent in Africa (about 20% of the population), the Mediterranean (4% – 30%) and southeast Asia. Clinical signs of haemolytic crisis emerge by ingesting certain foods or drugs, exposure to substances with intracellular oxidising effects on red blood cells, and the presence of bacterial and viral diseases, including COVID-19. Although several drugs and therapy techniques are still being studied, there has yet to be an approved treatment for COVID-19, leading to early explorations with hydroxychloroquine. This research examines hydroxychloroquine (HCQ) as a COVID-19 therapy option for patients with G6PDD and how health promotion, awareness, and self- management can help prevent adverse therapeutic reactions. Methods A systematic review of available literature was conducted till July 2022. Databases searched included EMBASE, MEDLINE, SCOPUS, Web of Science and Global Health. Two registers (Journals @OVID and Imperial@OVID) were also perused, along with snowballing methods for relevant evidence. The authors also critically appraised all included evidence using the Joanna Briggs Institute (JBI) and the National Heart, Lung, and Blood Institute (NHLBI) templates. Results Fifteen (4%) of 348 retrieved studies were eligible for narrative synthesis. Eleven (73%) were case reports, and four (27%) were cross-sectional studies. The age range observed in the case reports was 11 to 72 years (mean: 51). Patients learned of their G6PDD status in 10 (90%) of 11 case reports after being hospitalised. Nine (82%) of the 11 case reports mentioned the incidence of haemolytic anaemia following hydroxychloroqu ine administration in G6PD patients. Seven (64%) of the 11 case reports outlined the importance of knowing G6PDD status before administering hydroxychloroquine. However, five (71.4%) of these seven case reports involved patients needing to be aware of their G6PDd status. Two (50%) of the four cross-sectional studies revealed respondents' ignorance of G6PDD self-management, while one (25%) revealed respondents' awareness and no mention of G6PDD self-management. Conclusion COVID-19 infection can cause haemolytic crises in G6PDD, and hydroxychloroquine can exacerbate this reaction in the presence of comorbidities. The studies reviewed revealed a poor awareness of G6PDD and self-management. More work must be done to improve G6PDD screening, awareness, adversities, and self-management in most at-risk groups.