Afra TP et al comment our recent report entitled: “acute hemolysis by hydroxychloroquine (HCQ) was observed in G6PD-deficient patient with severe COVID-19 related lung injury” [1,2]. Afra et al. underlight ”confounding factors and inconsistencies” in our conclusion, linking acute drop in Hb in COVID-19 patient with suspected G6PD and HCQ treatment. We respectfully disagree with comments from Afra et al. Our case report was the first one of a series, linking G6PD deficiency with HCQ/CQ treatment for COVID19 infection such as Kuiper ME et al.