Very interesting hypothesis causally linking hemoglobin metabolism, oxygenation/deoxygenation at the lung and in tissues to Covid-19. So far, no sci. publications on this subject (searched in PUBMED).
However, old reviews on Hemoglobin metabolism in mammals are interesting. 1/n https://twitter.com/RajeevSrinivasa/status/1247786500080545794
. @RajeevSrinivasa
Science on Oxygenation / deoxygenation and its link to FEVER:

>> Due to the exothermic character of the
oxygenation process, a significant increase
of body temperature may result in a substantial
decrease of oxygen loading at the
level of the lungs. << 2/n
. @RajeevSrinivasa
One of the well studied and PROVEN biochemical reaction.

>>Iron is also biochemically dangerous; it can damage tissues by catalyzing the conversion of hydrogen peroxide to free-radical ions that attack cellular membranes, protein and DNA.<< 3/n
. @RajeevSrinivasa
In summary:
>> Covid-19 and lung involvement is REAL and cannot be ignored. Covid-19 enters cell via ACE-2 receptor and one another.
>> Covid-19 infection is due to defective immune attack on this virus. Hence aymptomatic carriers vs patients. 4/n
. @RajeevSrinivasa
>> Covid-19 in immunocompetent individuals is NOT a big issue. Virus is detected early, immune response is mounted on (both cellular and antibody mediated) and normalcy returns. [No cytokine storm in these patients; Age group: 10 to 45yr old]. 5/n
. @RajeevSrinivasa
>> Covid-19 binding to hemoglobin or Covid-19's presence in RBC has not been proven (as for as I know).
>> Free IRON load in blood or in tissues have not been proven yet in Covid-19 patients. [This, as per the hypothesis causes severe oxidative damage]. 6/n
. @RajeevSrinivasa
>> The guy who wrote the hypothesis is definitely NOT a physician and NOT a scientist. There are lots of wrong scientific facts in that hypothesis.
>> RBC does not have nucleus and no protein synthesis machinery. So, Covid-19 (RNA virus) can't replicate. 7/n
. @RajeevSrinivasa
>> Lung alvelolar macrophages (reactive immune cells) plus epithelial cells expressing ACE-2 receptor are MAJOR players in covid-19.
>> Cytokine STORM (IL-1beta, IL-6, TNF-alpha) is a BIG issue in Covid-19. Lung inflammation happens because of this. 8/n
Finally, therapy for Covid19 should address these:
>> Cytokine storm &NON-RESOLING lung inflammation
can be stopped by inflammasome inhibitors and use of anti-IL-6 therapy (evidence based)
> use of oxygenation, RBC, plasma transfusion
> Hydroxychloroquine plus zinc.
8/n. END.
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