Hypoferremia is associated with increased hospitalization and oxygen demand in COVID-19 patients

Iron metabolism might play a crucial role in cytokine release syndrome in COVID-19 patients. Therefore, we assessed iron metabolism markers in COVID-19 patients for their ability to predict disease severity. COVID-19 patients referred to the Heidelberg University Hospital were retrospectively analyz...

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Hauptverfasser: Wenz, Theresa (VerfasserIn) , Altamura, Sandro (VerfasserIn) , Muckenthaler, Martina (VerfasserIn) , Merle, Uta (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 10 November 2020
In: HemaSphere
Year: 2020, Jahrgang: 4, Heft: 6, Pages: 1-9
ISSN:2572-9241
DOI:10.1097/HS9.0000000000000492
Online-Zugang:Verlag, kostenfrei, Volltext: https://doi.org/10.1097/HS9.0000000000000492
Verlag, kostenfrei, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1097/HS9.0000000000000492
Volltext
Verfasserangaben:Theresa Hippchen, Sandro Altamura, Martina U. Muckenthaler, Uta Merle

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520 |a Iron metabolism might play a crucial role in cytokine release syndrome in COVID-19 patients. Therefore, we assessed iron metabolism markers in COVID-19 patients for their ability to predict disease severity. COVID-19 patients referred to the Heidelberg University Hospital were retrospectively analyzed. Patients were divided into outpatients (cohort A, n = 204), inpatients (cohort B, n = 81), and outpatients later admitted to hospital because of health deterioration (cohort C, n = 23). Iron metabolism parameters were severely altered in patients of cohort B and C compared to cohort A. In multivariate regression analysis including age, gender, CRP and iron-related parameters only serum iron and ferritin were significantly associated with hospitalization. ROC analysis revealed an AUC for serum iron of 0.894 and an iron concentration <6 μmol/l as the best cutoff-point predicting hospitalization with a sensitivity of 94.7% and a specificity of 67.9%. When stratifying inpatients in a low- and high oxygen demand group serum iron levels differed significantly between these two groups and showed a high negative correlation with the inflammatory parameters IL-6, procalcitonin, and CRP. Unexpectedly, serum iron levels poorly correlate with hepcidin. We conclude that measurement of serum iron can help predicting the severity of COVID-19. The differences in serum iron availability observed between the low and high oxygen demand group suggest that disturbed iron metabolism likely plays a causal role in the pathophysiology leading to lung injury. 
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