Depriving Iron Supply to the Virus Represents a Promising Adjuvant Therapeutic Against Viral Survival

Liu, Wei; Zhang, Shuping; Nekhai, Sergeï; Liu, Sijin

doi:10.1007/s40588-020-00140-w

Cited by 140 publications

(177 citation statements)

References 67 publications

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“…On the one hand, it is well known the importance of iron for the correct functioning of the immune system. However, it is also well established that iron-containing enzymes are essential for the completion of virus replication process, particularly coronaviruses [21]. Thus, it has been pointed out that iron chelation could be an alternative adjuvant strategy to treat COVID-19 patients, via manipulation of key iron regulators (still needs further research) or via venous injection or oral administration of iron chelators.…”

Section: The Role Of Specific Dietary Nutrients On Immune System Funcmentioning

confidence: 99%

Key Aspects in Nutritional Management of COVID-19 Patients

Fernández‐Quintela

Milton-Laskíbar

Trepiana

et al. 2020

JCM

122

114

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This review deals with the relationship among nutrition, the immune system, and coronavirus disease 2019 (COVID-19). The influence of nutrients and bioactive molecules present in foodstuffs on immune system activity, the influence of COVID-19 on the nutritional status of the patients, and the dietary recommendations for hospitalized patients are addressed. Deficient nutritional status is probably due to anorexia, nausea, vomiting, diarrhea, hypoalbuminemia, hypermetabolism, and excessive nitrogen loss. There is limited knowledge regarding the nutritional support during hospital stay of COVID-19 patients. However, nutritional therapy appears as first-line treatment and should be implemented into standard practice. Optimal intake of all nutrients, mainly those playing crucial roles in immune system, should be assured through a diverse and well-balanced diet. Nevertheless, in order to reduce the risk and consequences of infections, the intakes for some micronutrients may exceed the recommended dietary allowances since infections and other stressors can reduce micronutrient status. In the case of critically ill patients, recently published guidelines are available for their nutritional management. Further, several natural bioactive compounds interact with the angiotensin-converting enzyme 2 (ACE2) receptor, the gateway for severe acute respiratory syndrome (SARS) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Natural bioactive compounds can also reduce the inflammatory response induced by SARS-CoV-2. These compounds are potential beneficial tools in the nutritional management of COVID-19 patients.

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Section: The Role Of Specific Dietary Nutrients On Immune System Funcmentioning

confidence: 99%

Key Aspects in Nutritional Management of COVID-19 Patients

Fernández‐Quintela

Milton-Laskíbar

Trepiana

et al. 2020

JCM

122

114

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“…SARS-CoV-2 causes increasing in IL-1B, IFN-γ, and IP10 levels and so these cytokines cause increasing of hepcidin and Iron storage in macrophages and hepatocytes will be enhanced. High iron storage in these cells will help viral replication [31]. CQ and HCQ may inhibit the release of IL-6, IL-1B, and TNF-ɑ and so cause a decrease in hepcidin and inhibit viral replication [32].…”

Section: Iron (Ferrous)mentioning

confidence: 99%

A Review on the Serum Electrolytes and Trace Elements Role in the Pathophysiology of COVID-19

Taheri

Bahrami

Habibi

et al. 2020

Biol Trace Elem Res

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All the world is involved in the COVID-19 disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Coronavirus is a positive-sense RNA and has an envelope. There is no specific drug for this disease and treatment methods are limited. Malnutrition and electrolyte imbalance can make dysfunction in the immune system and impairment of the immune system causes increasing the risk of infection. Understanding the aspects of biological features of the virus will help the development of diagnostic tests, pharmacological therapies, and vaccines. Here, we review and discuss increasing and decreasing some trace elements and imbalance of serum and plasma electrolytes involving in COVID-19.

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“…Iron metabolism has been repeatedly proposed as a potential therapeutic target during infections [32,33]. Pharmacologic advances have made available safer iron chelators [34].…”

Section: Resultsmentioning

confidence: 99%

Iron metabolism and lymphocyte characterisation during Covid-19 infection in ICU patients: an observational cohort study.

Bolondi

Russo

Gamberini

et al. 2020

Preprint

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Abstract Background: Iron metabolism and immune response to SARS-CoV-2 have not been described yet in intensive care patients, although they are likely involved in Covid-19 pathogenesis.Methods: We performed an observational study during the peak of pandemic in our intensive care unit, dosing D-dimer, C-reactive protein, Troponin T, Lactate Dehydrogenase, Ferritin, Serum iron, Transferrin, Transferrin Saturation, Transferrin Soluble Receptor, Lymphocyte count and NK, CD3, CD4, CD8, B subgroups of 31 patients during the first two weeks of their ICU stay. Correlation with mortality and severity at the time of admission was tested with Spearman coefficient and Mann-Whitney test. Trends over time were tested with Kruskall-Wallis analysis.Results: Lymphopenia is severe and constant, with a nadir on day 2 of ICU stay (median 0.555 109/L; interquartile range (IQR) 0.450 109/L); all lymphocytic subgroups are dramatically reduced in critically ill patients, while CD4/CD8 ratio remains normal. Neither Ferritin nor lymphocyte count follow significant trends in ICU patients. Transferrin Saturation is extremely reduced at ICU admission (median 9%; IQR 7%), then significantly increases at day 3 to 6 (median 33%, IQR 26.5%, p-value 0.026). The same trend is observed with serum iron levels (median 25.5 µg/L, IQR 69 µg/L at admission; median 73 µg/L, IQR 56 µg/L on day 3 to 6) without reaching statistical significance. Hyperferritinemia is constant during intensive care stay: however, its dosage might be helpful in individuating patients developing hemophagocytic lymphohistiocytosis. D-dimer is elevated and progressively increases from admission (median 1319 µg/L; IQR 1285 µg/L) to day 3 to 6 (median 6820 µg/L; IQR 6619 µg/L), despite not reaching significant results. We describe trends of all the above mentioned parameters during ICU stay.Conclusions: The description of iron metabolism and lymphocyte count in Covid-19 patients admitted to the Intensive Care Unit provided with this paper might allow a wider understanding of SARS-CoV-2 pathophysiology.

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Depriving Iron Supply to the Virus Represents a Promising Adjuvant Therapeutic Against Viral Survival

Cited by 140 publications

References 67 publications

Key Aspects in Nutritional Management of COVID-19 Patients

Key Aspects in Nutritional Management of COVID-19 Patients

A Review on the Serum Electrolytes and Trace Elements Role in the Pathophysiology of COVID-19

Iron metabolism and lymphocyte characterisation during Covid-19 infection in ICU patients: an observational cohort study.

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