Hyperferritinemia in patients with COVID‐19: An opportunity for iron chelation?

Vlahakos, Vassilios; Marathias, Katerina; Arkadopoulos, Nikolaos; Vlahakos, Demetrios

doi:10.1111/aor.13812

Cited by 31 publications

(25 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Iron chelators have been used to treat cytokine storms and multi-organ injuries in a variety of environments, including ischemia-reperfusion injury, sepsis, and infections. Iron chelation has been shown to help with several viral infections, including HIV-1, hepatitis B, and mengovirus infection, among others [27]. Antiviral and immunomodulatory properties of iron chelator medications might help control SARS-CoV-2 and attenuate ARDS through a variety of mechanisms, including the inhibition of viral replication, reduction of iron availability, and up-regulation of B cells [28].…”

Section: Discussionmentioning

confidence: 99%

Iron Chelator or Iron Supplement Consumption in COVID-19? The Role of Iron with Severity Infection

Bastin

Shiri

Zanganeh

et al. 2021

Biol Trace Elem Res

View full text Add to dashboard Cite

Iron is a trace element that is used to replicate the virus and has a role in the vital functions of the body and the host's innate immune system. The mechanism of iron in COVID-19 severity is still not well understood. The aim of this study was to evaluate the association of the iron with COVID-19 severity. A case-control study was performed on 147 patients with a positive PCR test result and 39 normal individuals admitted to the Persian Gulf Martyrs Hospital in Bushehr, Iran. The iron profiles and related tests were measured along with hematological analytes. Hemoglobin (Hb), Fe, and saturated transferrin decreased in all the groups compared to the controls, but ferritin increased in the patient groups. After adjusting for age and sex, we found that increased ferritin levels augmented the odds ratio (OR) of the disease in the moderate (OR = 2.95, P = 0.007), severe (OR = 6.1, P < 0.001), and critical groups (OR = 8.34, P < 0.001). The decreased levels of Fe reduced the OR of the disease in the mild (OR = 0.96, P < 0.001), moderate (OR = 0.96, P < 0.001), severe (OR = 0.95, P < 0.001), and critical (OR = 0.98, P = 0.001) groups. Fe (AUC = 85.95, cutoff < 75.5 µg/dL, P < 0.001) and ferritin (AUC = 84.45, cutoff > 157.5 ng/dL, P < 0.001) have higher AUC for disease prognosis, but only ferritin (AUC = 74.89, cutoff > 261.5 ng/ dL, P < 0.001) has higher AUC for disease severity assays. It could be concluded that the use of iron chelators to reduce iron intake can be considered a therapeutic goal. In addition, measuring Fe and ferritin is beneficial for the diagnosis of the disease and determining its severity.

show abstract

Section: Discussionmentioning

confidence: 99%

Iron Chelator or Iron Supplement Consumption in COVID-19? The Role of Iron with Severity Infection

Bastin

Shiri

Zanganeh

et al. 2021

Biol Trace Elem Res

View full text Add to dashboard Cite

show abstract

“…Namely, under such aggressive OS, polyunsaturated fatty acids (PUFAs, notably ω-6 fatty acids or n-6 fatty acids, especially arachidonic and linoleic acid) in cellular biomembranes become targets for ROS-induced damage, triggering a self-catalyzed, non-enzymatic chain reaction of LPO. Thus, damaged cells in the affected tissues, together with erythrocytes in blood, generate ROS, and release of free iron, which can consequently amplify LPO through Fenton reactions and promote LPO and ferroptosis [ 6 ], resulting in membrane dysfunction/destruction and MOF in COVID-19 patients [ 7 ]. Indeed, the autopsy findings in COVID-19 patients revealed a ferroptosis signature in the epicardium and myocardium in the area of severe SARS-CoV-2 myocarditis associated with generalized lipid peroxidation [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Preliminary Findings on the Association of the Lipid Peroxidation Product 4-Hydroxynonenal with the Lethal Outcome of Aggressive COVID-19

et al. 2021

View full text Add to dashboard Cite

Major findings of the pilot study involving 21 critically ill patients during the week after admission to the critical care unit specialized for COVID-19 are presented. Fourteen patients have recovered, while seven passed away. There were no differences between them in respect to clinical or laboratory parameters monitored. However, protein adducts of the lipid peroxidation product 4-hydroxynonenal (HNE) were higher in the plasma of the deceased patients, while total antioxidant capacity was below the detection limit for the majority of sera samples in both groups. Moreover, levels of the HNE-protein adducts were constant in the plasma of the deceased patients, while in survivors, they have shown prominent and dynamic variations, suggesting that survivors had active oxidative stress response mechanisms reacting to COVID-19 aggression, which were not efficient in patients who died. Immunohistochemistry revealed the abundant presence of HNE-protein adducts in the lungs of deceased patients indicating that HNE is associated with the lethal outcome. It seems that HNE was spreading from the blood vessels more than being a consequence of pneumonia. Due to the limitations of the relatively small number of patients involved in this study, further research on HNE and antioxidants is needed. This might allow a better understanding of COVID-19 and options for utilizing antioxidants by personalized, integrative biomedicine approach to prevent the onset of HNE-mediated vitious circle of lipid peroxidation in patients with aggressive inflammatory diseases.

show abstract

“…For this reason, the iron-chelating agent, Deferoxamine, has been introduced in the management of COVID-19 69 , 70 .…”

Section: Covid-19 Disrupts the Possible Mitochondrial Role In Iron Homeostasismentioning

confidence: 99%

Of mitochondrion and COVID-19

Alfarouk

Alhoufie

Hifny

et al. 2021

Journal of Enzyme Inhibition and Medicinal Chemistry

View full text Add to dashboard Cite

COVID-19, a pandemic disease caused by a viral infection, is associated with a high mortality rate. Most of the signs and symptoms, e.g. cytokine storm, electrolytes imbalances, thromboembolism, etc., are related to mitochondrial dysfunction. Therefore, targeting mitochondrion will represent a more rational treatment of COVID-19. The current work outlines how COVID-19's signs and symptoms are related to the mitochondrion. Proper understanding of the underlying causes might enhance the opportunity to treat COVID-19.

show abstract

Hyperferritinemia in patients with COVID‐19: An opportunity for iron chelation?

Cited by 31 publications

References 22 publications

Iron Chelator or Iron Supplement Consumption in COVID-19? The Role of Iron with Severity Infection

Iron Chelator or Iron Supplement Consumption in COVID-19? The Role of Iron with Severity Infection

Preliminary Findings on the Association of the Lipid Peroxidation Product 4-Hydroxynonenal with the Lethal Outcome of Aggressive COVID-19

Of mitochondrion and COVID-19

Contact Info

Product

Resources

About