Evaluation of perturbed iron-homeostasis in a prospective cohort of patients with COVID-19

Wellcome Open Research

article

Joe N. Frost¹  Fergus Hamilton²  David Arnold³  Karen T. Elvers⁴  Akshay Shah⁵  Andrew E. Armitage¹  Alice Milne³  Jorgen McKernon³  Marie Attwood³  Yi-Ling Chen¹  Luzheng Xue⁶  Jonathan Youngs⁷  Nicholas M. Provine⁹  Tihana Bicanic⁷  Paul Klenerman⁹  Hal Drakesmith¹  Peter Ghazal⁴ 

[1] MRC Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford;MRC Integrative Epidemiology Unit, University of Bristol;North Bristol NHS Trust;Medicines Discovery Institute, Cardiff University;Nuffield Department of Clinical Neurosciences, University of Oxford;Respiratory Medicine Unit and Oxford NIHR Biomedical Research Centre, Nuffield Department of Medicine, University of Oxford;Institute for Infection and Immunity, St George's, University of London;Clinical Academic Group in Infection and Immunity, St George's Hospital;Peter Medawar Building for Pathogen Research, University of Oxford;Translational Gastroenterology Unit, Nuffield Department of Medicine, University of Oxford;Project Sepsis, Systems Immunity Research Institute, Division of Infection and Immunity, Cardiff University

关键词: iron;    COVID-19;    homeostasis;    ferritin;    haemoglobin;   

DOI  :  10.12688/wellcomeopenres.17904.1

学科分类：内科医学

来源: Wellcome

【 摘 要 】

Background: Marked reductions in serum iron concentrations are commonly induced during the acute phase of infection. This phenomenon, termed hypoferremia of inflammation, leads to inflammatory anemia, but could also have broader pathophysiological implications. In patients with coronavirus disease 2019 (COVID-19), hypoferremia is associated with disease severity and poorer outcomes, although there are few reported cohorts.Methods: In this study, we leverage a well characterised prospective cohort of hospitalised COVID-19 patients and perform a set of analyses focussing on iron and related biomarkers and both acute severity of COVID-19 and longer-term symptomatology.Results: We observed no associations between acute serum iron and long-term outcomes (including fatigue, breathlessness or quality of life); however, lower haemoglobin was associated with poorer quality of life. We also quantified iron homeostasis associated parameters, demonstrating that among 50 circulating mediators of inflammation IL-6 concentrations were strongly associated with serum iron, consistent with its central role in inflammatory control of iron homeostasis. Surprisingly, we observed no association between serum hepcidin and serum iron concentrations. We also observed elevated erythroferrone concentrations in COVID-19 patients with anaemia of inflammation.Conclusions: These results enhance our understanding of the regulation and pathophysiological consequences of disturbed iron homeostasis during SARS-CoV-2 infection.

【 授权许可】

CC BY