Impact of Anaemia and Dysregulated Iron Metabolism on COVID-19 Clinical Outcome – Review Article

Coronavirus disease-19 (COVID-19) is a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that can manifest in a wide range of forms, but the most common symptoms are fever, headache, fatigue, respiratory problems, lost sense of smell and taste, sore throat, muscle pain a...

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Main Authors: Matea Bogović, Robert Rončević, Stjepan Grga Milanković
Format: Article
Language:English
Published: Faculty of Medicine Osijek 2021-11-01
Series:Southeastern European Medical Journal
Subjects:
Online Access:http://seemedj.mefos.unios.hr/index.php/seemedj/article/view/211/116
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author Matea Bogović
Robert Rončević
Stjepan Grga Milanković
author_facet Matea Bogović
Robert Rončević
Stjepan Grga Milanković
author_sort Matea Bogović
collection DOAJ
description Coronavirus disease-19 (COVID-19) is a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that can manifest in a wide range of forms, but the most common symptoms are fever, headache, fatigue, respiratory problems, lost sense of smell and taste, sore throat, muscle pain and malaise. In patients with COVID-19, the inflammatory response of the organism affects iron homeostasis. Severe COVID-19 infections may lead to a hyperinflammatory condition, characterised by elevated ferritin levels that correlate with the severity of the clinical course, prolonged intensive care unit (ICU) stay, development of acute respiratory distress syndrome and a fatal outcome. As a result of iron metabolism disorders in inflammation, decreased erythropoiesis and reduced biological activity of erythropoietin, the erythrocyte half-life is shortened, leading to anaemia of chronic inflammation. Cytokine IL-6 plays the most crucial role in regulating iron concentration. It affects iron metabolism by producing hepcidin via STAT 3. Hepcidin produces regulatory effects on iron by binding with ferroportin, the only known transmembrane iron exporter. Anaemia has long been characterised as a significant risk factor contributing to increased mortality and poorer clinical outcomes for various infections. The most severe forms of COVID-19 infection result in pneumonia, causing a reduced supply of oxygen to the circulation, ultimately leading to ischemia of vital organs. Anaemia of chronic disease is more common in COVID-19 positive patients and is associated with a poorer clinical outcome. A higher ferritin/transferrin ratio indicates an advanced inflammatory condition and may be a predictive factor of ICU admission.
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spelling doaj.art-199a230b9af64875813f2545ae39b6e32022-12-21T18:33:14ZengFaculty of Medicine OsijekSoutheastern European Medical Journal2459-94842021-11-0152917http://dx.doi.org/10.26332/seemedj.v5i2.211Impact of Anaemia and Dysregulated Iron Metabolism on COVID-19 Clinical Outcome – Review ArticleMatea Bogović0Robert Rončević1Stjepan Grga Milanković2Department of Radiology, National Memorial Hospital Vukovar, Vukovar, CroatiaDepartment of Diagnostic and Interventional Radiology, Clinical Hospital Centre Osijek, Osijek, CroatiaDepartment of Otorhinolaryngology and Head and Neck Surgery, Clinical Hospital Centre Osijek, Osijek, CroatiaCoronavirus disease-19 (COVID-19) is a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that can manifest in a wide range of forms, but the most common symptoms are fever, headache, fatigue, respiratory problems, lost sense of smell and taste, sore throat, muscle pain and malaise. In patients with COVID-19, the inflammatory response of the organism affects iron homeostasis. Severe COVID-19 infections may lead to a hyperinflammatory condition, characterised by elevated ferritin levels that correlate with the severity of the clinical course, prolonged intensive care unit (ICU) stay, development of acute respiratory distress syndrome and a fatal outcome. As a result of iron metabolism disorders in inflammation, decreased erythropoiesis and reduced biological activity of erythropoietin, the erythrocyte half-life is shortened, leading to anaemia of chronic inflammation. Cytokine IL-6 plays the most crucial role in regulating iron concentration. It affects iron metabolism by producing hepcidin via STAT 3. Hepcidin produces regulatory effects on iron by binding with ferroportin, the only known transmembrane iron exporter. Anaemia has long been characterised as a significant risk factor contributing to increased mortality and poorer clinical outcomes for various infections. The most severe forms of COVID-19 infection result in pneumonia, causing a reduced supply of oxygen to the circulation, ultimately leading to ischemia of vital organs. Anaemia of chronic disease is more common in COVID-19 positive patients and is associated with a poorer clinical outcome. A higher ferritin/transferrin ratio indicates an advanced inflammatory condition and may be a predictive factor of ICU admission.http://seemedj.mefos.unios.hr/index.php/seemedj/article/view/211/116covid-19anaemiairon metabolismsars cov-2
spellingShingle Matea Bogović
Robert Rončević
Stjepan Grga Milanković
Impact of Anaemia and Dysregulated Iron Metabolism on COVID-19 Clinical Outcome – Review Article
Southeastern European Medical Journal
covid-19
anaemia
iron metabolism
sars cov-2
title Impact of Anaemia and Dysregulated Iron Metabolism on COVID-19 Clinical Outcome – Review Article
title_full Impact of Anaemia and Dysregulated Iron Metabolism on COVID-19 Clinical Outcome – Review Article
title_fullStr Impact of Anaemia and Dysregulated Iron Metabolism on COVID-19 Clinical Outcome – Review Article
title_full_unstemmed Impact of Anaemia and Dysregulated Iron Metabolism on COVID-19 Clinical Outcome – Review Article
title_short Impact of Anaemia and Dysregulated Iron Metabolism on COVID-19 Clinical Outcome – Review Article
title_sort impact of anaemia and dysregulated iron metabolism on covid 19 clinical outcome review article
topic covid-19
anaemia
iron metabolism
sars cov-2
url http://seemedj.mefos.unios.hr/index.php/seemedj/article/view/211/116
work_keys_str_mv AT mateabogovic impactofanaemiaanddysregulatedironmetabolismoncovid19clinicaloutcomereviewarticle
AT robertroncevic impactofanaemiaanddysregulatedironmetabolismoncovid19clinicaloutcomereviewarticle
AT stjepangrgamilankovic impactofanaemiaanddysregulatedironmetabolismoncovid19clinicaloutcomereviewarticle