Hyperferritinemia, Low Circulating Iron and Elevated Hepcidin May Negatively Impact Outcome in COVID-19 Patients: A Pilot Study

Szabó, Róbert; Petrișor, Cristina; Bodolea, Constantin; Šimon, Róbert; Mărieș, Ioana; Trancă, Sebastian; Mocan, Teodora

doi:10.3390/antiox11071364

Cited by 9 publications

(10 citation statements)

References 29 publications

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“…There were some studies that reported no changes in IL-6 levels [ 21 , 74 ]. Radulescu et al observed that repeated IL-6 measurements were not relevant for outcome prediction because the study observed a significant increase by days 3 and 7 in most patients.…”

Section: Resultsmentioning

confidence: 99%

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COVID-19 and Laboratory Markers from Romanian Patients—A Narrative Review

Musat,

Sorop,

Sorop

et al. 2023

Life

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COVID-19 has significantly impacted the whole world, and Romania was no exception. Biomarkers play a crucial role in understanding and managing the disease. However, research regarding laboratory analyses for patients with COVID-19 is fairly limited. For detection, PCR testing is still considered the golden standard, while antibodies are still useful for monitoring both patients and their vaccination status. In our country, biomarkers such as CRP, LDH, transaminases, cardiac, and iron markers have been used to assess the status of patients and even predict illness outcome. CRP, IL-6, LDH, FER, fibrinogen, creatinine, and vitamin D levels have been associated with increased severity, risk of ICU admission, and death. Cardiac markers and D-dimers are also good predictors, but their role seems more important in patients with complications. HDL cholesterol and BUN levels were also suggested as potential biomarkers. Hematological issues in SARS-CoV-2 infections include neutrophilia, lymphopenia and their ratio, while PCT, which is a marker of bacterial infections, is better to be used in patients with co- or supra-infections. The current research is a narrative review that focuses on the laboratory results of Romanian COVID-19 patients. The goal of this article is to provide an update on the research on biomarkers and other laboratory tests conducted inside the borders of Romania and identify gaps in this regard. Secondly, options for further research are discussed and encouraged.

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Section: Resultsmentioning

confidence: 99%

“…Normal cardiac markers were observed in a few studies [ 21 , 86 ], while elevated levels were observed in others [ 23 , 37 , 45 , 63 , 74 ]. Furthermore, cardiac markers varied by NYHA classification and were considered an independent risk factor [ 33 ].…”

Section: Resultsmentioning

confidence: 99%

COVID-19 and Laboratory Markers from Romanian Patients—A Narrative Review

Musat,

Sorop,

Sorop

et al. 2023

Life

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“…According to data, high ferritin levels and anaemia may contribute to multiple organ failures in the disease [ 27 ]. Inflammation also causes increased secretion of hepcidine, which contributes to hypoferremia [ 28 ]. Our study showed that iron levels in the test sera were almost two times below reference values regardless of the patient’s clinical condition.…”

Section: Discussionmentioning

confidence: 99%

Severe COVID-19 classified by simple covid risk index is associated with higher levels of advanced oxidation protein products and 8-hydroxy 2 deoxyguanosine

Satała¹,

Woźniak²,

Fabiś³

et al. 2023

Epidemiol. Infect.

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SARS-CoV-2 has become one of the most important and challenging medical research topics in recent years. The presence of endothelial dysfunction, immune thrombosis, and oxidative stress contributes to complications and requires more extended hospitalisation of patients. In this article, we focused on analysing the impact of oxidative stress on the severity of COVID-19 infection. The study group consisted of 72 patients with laboratory-confirmed SARS-CoV enrolled. The patients were divided into moderate and severe diseases according to the SCRI (Simple Covid Risk Index, including lymphocyte/D-dimer ratio). Using the ELISA kit, we determined the level of AOPP and 8-OHdG. Patients with severe COVID-19 had higher levels of both AOPP (P < 0.05) and 8-OHdG (P < 0.05) compared to patients with moderate disease. Albumin levels were significantly lower (P < 0.001), although fibrinogen (P < 0.01), D-dimer (P < 0.001), and TF (P < 0.05) levels were higher in severe patients than in moderate course. AOPP/Alb was also higher among severe patients (P < 0.05). Our data suggest a potential role for AOPP and 8-OHdG in predicting the outcome of SARS-CoV-2 patients. Elevated AOPP levels were associated with increased Dimer-D, TF, and vWF activity levels.

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“…To assess if the effects were produced by tocilizumab, controls were matched by age, sex, and comorbidity. The control group was comprised of patients from a cohort enrolled for a concomitant study during the same period [ 14 ]. Patients in the control group followed the same inclusion and exclusion criteria.…”

Section: Methodsmentioning

confidence: 99%

Effects of Tocilizumab on Inflammation and Iron Metabolism in Critically Ill Patients with COVID-19

et al. 2023

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COVID-19 produces cytokine-mediated persistent inflammation and is associated with elevated iron stores and low circulating iron. It is believed that central to the pathophysiological mechanism is interleukin 6 and hepcidin. A state of iron overload, termed hyperferritinemia, and inflammatory anemia take place. Both conditions are linked to a worse result in critically ill patients. Blocking the interleukin 6—hepcidin pathway with Tocilizumab could present favorable outcomes. The aim of this study was to evaluate if Tocilizumab influences survival, the occurrence of sepsis, anemia and transfusions in critically ill patients suffering from COVID-19. This prospective observational study focused on levels of interleukin 6, hepcidin and blood iron parameters in patients treated with Tocilizumab. Data were compared before and after therapy as well as between treated and control groups. Results indicate that there is no difference in terms of survival nor in the rate of anemia or sepsis occurrence. Hepcidin was elevated and anemia ensued after treatment, which could indicate alternative pathways. In conclusion, when the classic interleukin 6—hepcidin pathway is blocked, inflammation seems to use alternative routes. Further understanding of these pathways is required and new pharmacological therapies need to be developed to treat persistent inflammation.

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Hyperferritinemia, Low Circulating Iron and Elevated Hepcidin May Negatively Impact Outcome in COVID-19 Patients: A Pilot Study

Cited by 9 publications

References 29 publications

COVID-19 and Laboratory Markers from Romanian Patients—A Narrative Review

COVID-19 and Laboratory Markers from Romanian Patients—A Narrative Review

Severe COVID-19 classified by simple covid risk index is associated with higher levels of advanced oxidation protein products and 8-hydroxy 2 deoxyguanosine

Effects of Tocilizumab on Inflammation and Iron Metabolism in Critically Ill Patients with COVID-19

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