tetano
Editor, Senior Moderator
Respir Res
. 2020 Oct 21;21(1):276.
doi: 10.1186/s12931-020-01546-2.
Persisting alterations of iron homeostasis in COVID-19 are associated with non-resolving lung pathologies and poor patients' performance: a prospective observational cohort study
Thomas Sonnweber[SUP] 1 [/SUP], Anna Boehm[SUP] 1 [/SUP], Sabina Sahanic[SUP] 1 [/SUP], Alex Pizzini[SUP] 1 [/SUP], Magdalena Aichner[SUP] 1 [/SUP], Bettina Sonnweber[SUP] 2 [/SUP], Katharina Kurz[SUP] 1 [/SUP], Sabine Koppelst?tter[SUP] 1 [/SUP], David Haschka[SUP] 1 [/SUP], Verena Petzer[SUP] 3 [/SUP], Richard Hilbe[SUP] 1 [/SUP], Markus Theurl[SUP] 4 [/SUP], Daniela Lehner[SUP] 4 [/SUP], Manfred Nairz[SUP] 1 [/SUP], Bernhard Puchner[SUP] 5 [/SUP], Anna Luger[SUP] 6 [/SUP], Christoph Schwabl[SUP] 6 [/SUP], Rosa Bellmann-Weiler[SUP] 1 [/SUP], Ewald W?ll[SUP] 2 [/SUP], Gerlig Widmann[SUP] 6 [/SUP], Ivan Tancevski[SUP] 1 [/SUP], Judith-L?ffler-Ragg[SUP] 1 [/SUP], G?nter Weiss[SUP] 7 8 [/SUP]
Affiliations
Abstract
Background: Severe coronavirus disease 2019 (COVID-19) is frequently associated with hyperinflammation and hyperferritinemia. The latter is related to increased mortality in COVID-19. Still, it is not clear if iron dysmetabolism is mechanistically linked to COVID-19 pathobiology.
Methods: We herein present data from the ongoing prospective, multicentre, observational CovILD cohort study (ClinicalTrials.gov number, NCT04416100), which systematically follows up patients after COVID-19. 109 participants were evaluated 60 days after onset of first COVID-19 symptoms including clinical examination, chest computed tomography and laboratory testing.
Results: We investigated subjects with mild to critical COVID-19, of which the majority received hospital treatment. 60 days after disease onset, 30% of subjects still presented with iron deficiency and 9% had anemia, mostly categorized as anemia of inflammation. Anemic patients had increased levels of inflammation markers such as interleukin-6 and C-reactive protein and survived a more severe course of COVID-19. Hyperferritinemia was still present in 38% of all individuals and was more frequent in subjects with preceding severe or critical COVID-19. Analysis of the mRNA expression of peripheral blood mononuclear cells demonstrated a correlation of increased ferritin and cytokine mRNA expression in these patients. Finally, persisting hyperferritinemia was significantly associated with severe lung pathologies in computed tomography scans and a decreased performance status as compared to patients without hyperferritinemia.
Discussion: Alterations of iron homeostasis can persist for at least two months after the onset of COVID-19 and are closely associated with non-resolving lung pathologies and impaired physical performance. Determination of serum iron parameters may thus be a easy to access measure to monitor the resolution of COVID-19.
Trial registration: ClinicalTrials.gov number: NCT04416100.
Keywords: COVID-19; Hepcidin; Hyperferritinemia; Iron metabolism; SARS-CoV-2.
. 2020 Oct 21;21(1):276.
doi: 10.1186/s12931-020-01546-2.
Persisting alterations of iron homeostasis in COVID-19 are associated with non-resolving lung pathologies and poor patients' performance: a prospective observational cohort study
Thomas Sonnweber[SUP] 1 [/SUP], Anna Boehm[SUP] 1 [/SUP], Sabina Sahanic[SUP] 1 [/SUP], Alex Pizzini[SUP] 1 [/SUP], Magdalena Aichner[SUP] 1 [/SUP], Bettina Sonnweber[SUP] 2 [/SUP], Katharina Kurz[SUP] 1 [/SUP], Sabine Koppelst?tter[SUP] 1 [/SUP], David Haschka[SUP] 1 [/SUP], Verena Petzer[SUP] 3 [/SUP], Richard Hilbe[SUP] 1 [/SUP], Markus Theurl[SUP] 4 [/SUP], Daniela Lehner[SUP] 4 [/SUP], Manfred Nairz[SUP] 1 [/SUP], Bernhard Puchner[SUP] 5 [/SUP], Anna Luger[SUP] 6 [/SUP], Christoph Schwabl[SUP] 6 [/SUP], Rosa Bellmann-Weiler[SUP] 1 [/SUP], Ewald W?ll[SUP] 2 [/SUP], Gerlig Widmann[SUP] 6 [/SUP], Ivan Tancevski[SUP] 1 [/SUP], Judith-L?ffler-Ragg[SUP] 1 [/SUP], G?nter Weiss[SUP] 7 8 [/SUP]
Affiliations
- PMID: 33087116
- DOI: 10.1186/s12931-020-01546-2
Abstract
Background: Severe coronavirus disease 2019 (COVID-19) is frequently associated with hyperinflammation and hyperferritinemia. The latter is related to increased mortality in COVID-19. Still, it is not clear if iron dysmetabolism is mechanistically linked to COVID-19 pathobiology.
Methods: We herein present data from the ongoing prospective, multicentre, observational CovILD cohort study (ClinicalTrials.gov number, NCT04416100), which systematically follows up patients after COVID-19. 109 participants were evaluated 60 days after onset of first COVID-19 symptoms including clinical examination, chest computed tomography and laboratory testing.
Results: We investigated subjects with mild to critical COVID-19, of which the majority received hospital treatment. 60 days after disease onset, 30% of subjects still presented with iron deficiency and 9% had anemia, mostly categorized as anemia of inflammation. Anemic patients had increased levels of inflammation markers such as interleukin-6 and C-reactive protein and survived a more severe course of COVID-19. Hyperferritinemia was still present in 38% of all individuals and was more frequent in subjects with preceding severe or critical COVID-19. Analysis of the mRNA expression of peripheral blood mononuclear cells demonstrated a correlation of increased ferritin and cytokine mRNA expression in these patients. Finally, persisting hyperferritinemia was significantly associated with severe lung pathologies in computed tomography scans and a decreased performance status as compared to patients without hyperferritinemia.
Discussion: Alterations of iron homeostasis can persist for at least two months after the onset of COVID-19 and are closely associated with non-resolving lung pathologies and impaired physical performance. Determination of serum iron parameters may thus be a easy to access measure to monitor the resolution of COVID-19.
Trial registration: ClinicalTrials.gov number: NCT04416100.
Keywords: COVID-19; Hepcidin; Hyperferritinemia; Iron metabolism; SARS-CoV-2.