Hemoglobin levels are significantly lower in patients infected with Plasmodium vivax and Plasmodium falciparum than those with negative reactions . When widespread anemia occurs, oxygen delivery to tissues may be further compromised(115). However, parasitemia is not associated with anemia in patients infected with Plasmodium vivax or Plasmodium falciparum . Antibodies against red blood cells and anticardiolipin are not associated with the presence or severity of anemia . 2,3-diphosphoglycerate (BPG) interacts with hemoglobin molecules to increase P50, thereby promoting oxygen release. Metabolic acidosis is a significant predictor of hemoglobin-oxygen dissociation in severe childhood Plasmodium falciparum malaria(116). Acidosis, such as the excruciating pain associated with diabetic ketoacidosis(117), can impair BPG synthesis(118). There is a decrease in BPG in animals with severe malaria, according to studies(119). After the BPG concentration decreases, the oxygen dissociation curve shifts to the left(120). COVID-19 patients have active erythrocyte glycolysis . It was not ruled out that the BPG enhanced hemoglobin's oxygen-supply function in damaged erythrocytes(121).