Studies in such respect are limited or nothing published as I know. Reaching of COVID-19 to lungs cells interact and attach with lung cells , making certain blood viscosity and /clotting that decreases gaseous exchange and in turn loading of oxygen to hemoglobin is decreased . This decreases ATP and energy and causes death. Entry of such virus to RBCs and its behaviour in other cells is still obscure.

In PubMed four entries when the search terms "sars-cov-2 erythrocyte" are applied, but no reference to infected erythrocytes.

Hi, I am a research asistant ın COVID-19 ICU

According to my own observations,

WBC and ıts subdivisions are affected earlier than RBCs, especially during periods of cytokine storms. In individuals with progressive disease and clinical mortality, the hemopoietic cascade is completely disrupted and pancytopenia is seen.

A hypothesis( The effect of SARS coronavirus on blood system: its clinical findings and the pathophysiologic hypothesis. Yang M1, Hon KL, Li K, Fok TF, Li CK. ) is foreseen on this topic that can help you.

COVID affects the hematopoietic system in a way that

....' The possible mechanisms of this coronavirus on blood system may include (1) directly infect blood cells and bone marrow stromal cells via CD13 or CD66a; and/or (2) induce autoantibodies and immune complexes to damage these cells'.....

Link: Article The effect of SARS coronavirus on blood system: its clinical...

Thank you all, thank you Esra. I am aware of cytokine storm in some patients, which event lead to decrease of blood cell number, increased ferritin level, etc. While its clear COVID affects the hematopoietic system I think it too early to suggest it infect blood cells without actually performing quantitative measurements. I m thinking label free imaging could actually do such investigation.

Hypothetical grey medical literature but no clinical study indication of hemolytic anemia or porphyria in COVID-19 affected patients

On literature review, I could find 2 articles on COVID-19 purporting involvement of hemoglobin or Red Blood Cells. “COVID-19: Attacks the 1-Beta Chain of Hemoglobin and Captures the Porphyrin to Inhibit Human Heme Metabolism." Another article contested and criticized the methodology used in the in article 2 (3). Another article put forward a hypothesis of acute porphyria due to COVID-19 (4).

I could not find any study indicating hemolytic anemia which would be the natural result of hemoglobin disruption in the RBC. Similarly, there are no reports of increased prevalence of of porphyria-like symptoms in COVID-19 patients.

The anemia in COVID-19 is mainly normocytic normochromic and this may be the result of acute COVID-19 related acute viremic illness or secondary bacterial sepsis that causes bone marrow suppression.

Medical community should separate chaff from the wheat and should not be influenced by grey medical literature being published easily in the time of COVID-19 pandemic.

1. Presentation Covid-19 may be acting like a Trojan Horse: Novel target hem...

2. https://chemrxiv.org/articles/COVID-19_Disease_ORF8_and_Surface_Glycoprotein_Inhibit_Heme_Metabolism_by_Binding_to_Porphyrin/11938173

3. https://chemrxiv.org/articles/Flawed_methods_in_COVID-19_Attacks_the_1-Beta_Chain_of_Hemoglobin_and_Captures_the_Porphyrin_to_Inhibit_Human_Heme_Metabolism_/12120912

4. Preprint Covid-19: acquired acute porphyria hypothesis

Thank you Sir. I knew the 2nd reference, from ChemArvix by Liu and Li, but this is a computational method and I don't find any of the evidence satisfying to supports the claims, so I did not mentioned it. I would like to see some quantitative investigation but as you said, there is no report for hemolyic anemia. The fact you mention secondary bacterial sepsis is of interest. If bacteria do some damages, arguably it would increase the difficulty in identifying the leading causes of mortality.

Gamal Enan yes indeed, you mention that lung are affected so in return we observe a desaturation in patients, but there are reports of loss of blood cells in the absence of acute respiratory syndroms. So, this loss of red blood cells may comes from multiple causes, hence my question. (several hypothesis, including hyperinflammation & cytokyne storm, etc.)

following

Be careful about what you read. One of the many things that are under stress at this extraordinary time is the journal review system ...

https://retractionwatch.com/2020/06/15/a-journal-took-three-days-to-accept-a-covid-19-paper-its-taken-two-months-and-counting-to-retract-it/

It should be easy to locate the virus inside these cells. If you want to prove your hypothesis try to locate SARS-CoV-2 genetic material by qPCR or some structural protein by WB, IF or flow cytometry maybe.

There are two recent studies with evidences of erythrocytic insult in COVID-19.

Article ERYTHROCYTES AS A TARGET OF SARS COV-2 IN PATHOGENESIS OF COVID-19

Article Evidence of Structural Protein Damage and Membrane Lipid Rem...

We had also observed leucocyte changes are much later (at least 48 hours in our study; under consideration for publication) than red cells. However, neither our nor the previous two studies had gather any direct evidence for virus entry in the erythrocytes.

Yes, we do also believe that, pls read the article:

SARS-CoV-2 and Plasmodium falciparum common immunodominant regions may explain low COVID-19 incidence in the malaria-endemic belt.

New Microbes New Infect. 2020 Nov; 38: 100817. doi: 10.1016/j.nmni.2020.100817