Increased serum catalytic iron may mediate tissue injury and death in patients with COVID-19

Abstract The pathophysiology and the factors determining disease severity in COVID-19 are not yet clear, with current data indicating a possible role of altered iron metabolism. Previous studies of iron parameters in COVID-19 are cross-sectional and have not studied catalytic iron, the biologically...

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Autores principales:	Vipul Chakurkar, Mohan Rajapurkar, Suhas Lele, Banibrata Mukhopadhyay, Valentine Lobo, Ramakrishna Injarapu, Muddassir Sheikh, Bharatkumar Dholu, Arpita Ghosh, Vivekanand Jha
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/e016e88525874df69a4ca56277e2bb3a
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spelling	oai:doaj.org-article:e016e88525874df69a4ca56277e2bb3a2021-12-02T19:16:14ZIncreased serum catalytic iron may mediate tissue injury and death in patients with COVID-1910.1038/s41598-021-99142-x2045-2322https://doaj.org/article/e016e88525874df69a4ca56277e2bb3a2021-10-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-99142-xhttps://doaj.org/toc/2045-2322Abstract The pathophysiology and the factors determining disease severity in COVID-19 are not yet clear, with current data indicating a possible role of altered iron metabolism. Previous studies of iron parameters in COVID-19 are cross-sectional and have not studied catalytic iron, the biologically most active form of iron. The study was done to determine the role of catalytic iron in the adverse outcomes in COVID-19. We enrolled adult patients hospitalized with a clinical diagnosis of COVID-19 and measured serum iron, transferrin saturation, ferritin, hepcidin and serum catalytic iron daily. Primary outcome was a composite of in-hospital mortality, need for mechanical ventilation, and kidney replacement therapy. Associations between longitudinal iron parameter measurements and time-to-event outcomes were examined using a joint model. We enrolled 120 patients (70 males) with median age 50 years. The primary composite outcome was observed in 25 (20.8%) patients—mechanical ventilation was needed in 21 (17.5%) patients and in-hospital mortality occurred in 21 (17.5%) patients. Baseline levels of ferritin and hepcidin were significantly associated with the primary composite outcome. The joint model analysis showed that ferritin levels were significantly associated with primary composite outcome [HR (95% CI) = 2.63 (1.62, 4.24) after adjusting for age and gender]. Both ferritin and serum catalytic iron levels were positively associated with in-hospital mortality [HR (95% CI) = 3.22 (2.05, 5.07) and 1.73 (1.21, 2.47), respectively], after adjusting for age and gender. The study shows an association of ferritin and catalytic iron with adverse outcomes in COVID-19. This suggests new pathophysiologic pathways in this disease, also raising the possibility of considering iron chelation therapy.Vipul ChakurkarMohan RajapurkarSuhas LeleBanibrata MukhopadhyayValentine LoboRamakrishna InjarapuMuddassir SheikhBharatkumar DholuArpita GhoshVivekanand JhaNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Vipul Chakurkar Mohan Rajapurkar Suhas Lele Banibrata Mukhopadhyay Valentine Lobo Ramakrishna Injarapu Muddassir Sheikh Bharatkumar Dholu Arpita Ghosh Vivekanand Jha Increased serum catalytic iron may mediate tissue injury and death in patients with COVID-19
description	Abstract The pathophysiology and the factors determining disease severity in COVID-19 are not yet clear, with current data indicating a possible role of altered iron metabolism. Previous studies of iron parameters in COVID-19 are cross-sectional and have not studied catalytic iron, the biologically most active form of iron. The study was done to determine the role of catalytic iron in the adverse outcomes in COVID-19. We enrolled adult patients hospitalized with a clinical diagnosis of COVID-19 and measured serum iron, transferrin saturation, ferritin, hepcidin and serum catalytic iron daily. Primary outcome was a composite of in-hospital mortality, need for mechanical ventilation, and kidney replacement therapy. Associations between longitudinal iron parameter measurements and time-to-event outcomes were examined using a joint model. We enrolled 120 patients (70 males) with median age 50 years. The primary composite outcome was observed in 25 (20.8%) patients—mechanical ventilation was needed in 21 (17.5%) patients and in-hospital mortality occurred in 21 (17.5%) patients. Baseline levels of ferritin and hepcidin were significantly associated with the primary composite outcome. The joint model analysis showed that ferritin levels were significantly associated with primary composite outcome [HR (95% CI) = 2.63 (1.62, 4.24) after adjusting for age and gender]. Both ferritin and serum catalytic iron levels were positively associated with in-hospital mortality [HR (95% CI) = 3.22 (2.05, 5.07) and 1.73 (1.21, 2.47), respectively], after adjusting for age and gender. The study shows an association of ferritin and catalytic iron with adverse outcomes in COVID-19. This suggests new pathophysiologic pathways in this disease, also raising the possibility of considering iron chelation therapy.
format	article
author	Vipul Chakurkar Mohan Rajapurkar Suhas Lele Banibrata Mukhopadhyay Valentine Lobo Ramakrishna Injarapu Muddassir Sheikh Bharatkumar Dholu Arpita Ghosh Vivekanand Jha
author_facet	Vipul Chakurkar Mohan Rajapurkar Suhas Lele Banibrata Mukhopadhyay Valentine Lobo Ramakrishna Injarapu Muddassir Sheikh Bharatkumar Dholu Arpita Ghosh Vivekanand Jha
author_sort	Vipul Chakurkar
title	Increased serum catalytic iron may mediate tissue injury and death in patients with COVID-19
title_short	Increased serum catalytic iron may mediate tissue injury and death in patients with COVID-19
title_full	Increased serum catalytic iron may mediate tissue injury and death in patients with COVID-19
title_fullStr	Increased serum catalytic iron may mediate tissue injury and death in patients with COVID-19
title_full_unstemmed	Increased serum catalytic iron may mediate tissue injury and death in patients with COVID-19
title_sort	increased serum catalytic iron may mediate tissue injury and death in patients with covid-19
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/e016e88525874df69a4ca56277e2bb3a
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Increased serum catalytic iron may mediate tissue injury and death in patients with COVID-19

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