Effect of Altered Iron Metabolism on Hyperinflammation and Coagulopathy in Patients with Critical COVID-19: A Retrospective Study

ABSTRACT

A novel coronavirus disease 2019 (COVID-19) outbreak has started in Wuhan, China, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The relationship between altered iron homeostasis and hyperinflammation may be hallmarks of COVID-19 disease. We aimed to compare some iron (ferritin and iron), inflammation (C-reactive protein [CRP], hemoglobin, lactate dehydrogenase [LDH], neutrophil) and coagulation (prothrombin time [PT], activated partial thromboplastin time [APTT], D-dimer, platelet) marker results of critical COVID-19 patients with healthy controls results. In this single center retrospective study, 50 critical patients diagnosed with COVID-19 were included, demographic, clinical characteristics, severity of disease and laboratory test results were elicited from electronic medical records and compared to 50 healthy people. A statistically significant increase in CRP, LDH, neutrophil, PT, APTT, D-dimer ferritin levels was observed in critical COVID-19 patients compared with healthy people while a statistically significant decrease was observed in hemoglobin and iron levels. In addition, no statistically significant change in platelet levels was observed. Ferroptosis may be a significant cause of multiple organ failure in critical COVID-19 patients. Ferroptosis inhibitors might have potential to combat ferroptosis in COVID-19. Therefore, larger studies are needed to ferroptosis in COVID-19 in vivo and in vitro.