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Microbes & Immunity Anemia among COVID-19 patients in Ethiopia

Figure 3. Forest plot of ten studies on the prevalence of anemia among coronavirus disease 2019 patients in Ethiopia
Abbreviation: CI: Confidence interval.

Figure 4. Leave-one-out meta-analysis to see the influence of the single study on the pooled effect size
Abbreviations: CI: Confidence interval; REML: Restricted maximum likelihood.

is considered mild, moderate, or severe when its prevalence between the beta chains of hemoglobin, open reading
exceeds 5%, 20%, or 40%, respectively. 24 frame 8, and the surface glycoproteins of the virus leads
A scientific explanation for anemia among COVID-19 to a decline in hemoglobin levels during SARS-CoV-2
patients is that SARS-CoV-2 directly infects erythroid infection. 26,27 Another contributing factor to anemia
precursor cells, impairs hemoglobin homeostasis, and during SARS-CoV-2 infection is the presence of ACE 2
worsens the severity of COVID-19. This leads to impaired receptors in kidney cells, such as podocytes and proximal
porphyrin metabolism and changes in the expression tubular epithelial cells, which reduces erythropoietin
28
of key enzymes involved in iron and hemoglobin synthesis. This results in a decrease in hemoglobin levels
metabolism. Furthermore, SARS-CoV-2 inhibits heme during SARS-CoV-2 infection and exacerbates COVID-19
25-27
metabolism and induces hemoglobin denaturation during disease.
erythrocyte development. SARS-CoV-2 interacts with Furthermore, the presence of SARS-CoV-2, such as
25
protoporphyrin IX through spike protein 1, causing the transmembrane serine protease 2, CD147, and CD26 in
dissociation of iron from porphyrin. The interaction erythroid progenitor cells in bone marrow, makes them a

Volume 2 Issue 2 (2025) 122 doi: 10.36922/mi.3504