With several contradictory reports on the efficacy of hydroxychloroquine (HCQ) on COVID-19, the Indian Council of Medical Research (ICMR) recommended its use for prophylaxis and treatment of mild cases during the first wave of the pandemic. Amidst all the controversies, there have been a few cases reported of significant methemoglobinemia and hemolysis in COVID-19 cases being treated with HCQ. The diagnosis of methemoglobinemia amidst this COVID-19 crisis is really challenging owing to similar clinical manifestations. We present a case series where methemoglobinemia was promptly detected and managed efficiently, resulting in the uneventful discharge of all three cases. This is to be understood that undiagnosed cases of methemoglobinemia can be potentially fatal due to hypoxic stress on the body. If the condition is not being detected timely, leading to dangerous levels of untreated methemoglobinemia may cause a case of fatality falsely attributed to COVID-19. However, when the HCQ is not being used for COVID-19 presently, still clinicians must know different drugs that can cause methemoglobinemia and should promptly intervene to avoid any catastrophe.
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