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Anemia and iron metabolism in COVID-19: a systematic review and meta-analysis.
Taneri, Petek Eylul; Gómez-Ochoa, Sergio Alejandro; Llanaj, Erand; Raguindin, Peter Francis; Rojas, Lyda Z; Roa-Díaz, Zayne Milena; Salvador, Dante; Groothof, Dion; Minder, Beatrice; Kopp-Heim, Doris; Hautz, Wolf E; Eisenga, Michele F; Franco, Oscar H; Glisic, Marija; Muka, Taulant.
  • Taneri PE; Public Health Department, Faculty of Medicine, Bahcesehir University, Istanbul, Turkey.
  • Gómez-Ochoa SA; Public Health and Epidemiological Studies Group, Cardiovascular Foundation of Colombia, Floridablanca, Colombia.
  • Llanaj E; Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary.
  • Raguindin PF; Public Health Research Institute, University of Debrecen, Debrecen, Hungary.
  • Rojas LZ; Institute of Social and Preventive Medicine (ISPM), University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland.
  • Roa-Díaz ZM; Institute of Child Health and Human Development (ICHHD), National Institutes of Health, University of the Philippines Manila, Manila, Philippines.
  • Salvador D; Swiss Paraplegic Research, Nottwil, Switzerland.
  • Groothof D; Public Health and Epidemiological Studies Group, Cardiovascular Foundation of Colombia, Floridablanca, Colombia.
  • Minder B; Research Group and Development of Nursing Knowledge (GIDCEN-FCV), Research Institute, Cardiovascular Foundation of Colombia, Floriadablanca, Santander, Colombia.
  • Kopp-Heim D; Institute of Social and Preventive Medicine (ISPM), University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland.
  • Hautz WE; Institute of Social and Preventive Medicine (ISPM), University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland.
  • Eisenga MF; Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
  • Franco OH; Public Health & Primary Care Library, University Library of Bern, University of Bern, Bern, Switzerland.
  • Glisic M; Public Health & Primary Care Library, University Library of Bern, University of Bern, Bern, Switzerland.
  • Muka T; Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Eur J Epidemiol ; 35(8): 763-773, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-725658
Preprint
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Semantic information from SemMedBD (by NLM)
1. iron metabolism COEXISTS_WITH COVID-19
Subject
iron metabolism
Predicate
COEXISTS_WITH
Object
COVID-19
2. Anemia AFFECTS Multiple Organ Failure
Subject
Anemia
Predicate
AFFECTS
Object
Multiple Organ Failure
3. Multiple Organ Failure COEXISTS_WITH COVID-19
Subject
Multiple Organ Failure
Predicate
COEXISTS_WITH
Object
COVID-19
4. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
5. iron metabolism PROCESS_OF Patients
Subject
iron metabolism
Predicate
PROCESS_OF
Object
Patients
6. Patients LOCATION_OF Hemoglobin
Subject
Patients
Predicate
LOCATION_OF
Object
Hemoglobin
7. Ferritin level NEG_COEXISTS_WITH Hemoglobin concentration result
Subject
Ferritin level
Predicate
NEG_COEXISTS_WITH
Object
Hemoglobin concentration result
8. iron metabolism COEXISTS_WITH COVID-19
Subject
iron metabolism
Predicate
COEXISTS_WITH
Object
COVID-19
9. Anemia AFFECTS Multiple Organ Failure
Subject
Anemia
Predicate
AFFECTS
Object
Multiple Organ Failure
10. Multiple Organ Failure COEXISTS_WITH COVID-19
Subject
Multiple Organ Failure
Predicate
COEXISTS_WITH
Object
COVID-19
11. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
12. iron metabolism PROCESS_OF Patients
Subject
iron metabolism
Predicate
PROCESS_OF
Object
Patients
13. Patients LOCATION_OF Hemoglobin
Subject
Patients
Predicate
LOCATION_OF
Object
Hemoglobin
14. Ferritin level NEG_COEXISTS_WITH Hemoglobin concentration result
Subject
Ferritin level
Predicate
NEG_COEXISTS_WITH
Object
Hemoglobin concentration result
ABSTRACT
Iron metabolism and anemia may play an important role in multiple organ dysfunction syndrome in Coronavirus disease 2019 (COVID-19). We conducted a systematic review and meta-analysis to evaluate biomarkers of anemia and iron metabolism (hemoglobin, ferritin, transferrin, soluble transferrin receptor, hepcidin, haptoglobin, unsaturated iron-binding capacity, erythropoietin, free erythrocyte protoporphyrine, and erythrocyte indices) in patients diagnosed with COVID-19, and explored their prognostic value. Six bibliographic databases were searched up to August 3rd 2020. We included 189 unique studies, with data from 57,563 COVID-19 patients. Pooled mean hemoglobin and ferritin levels in COVID-19 patients across all ages were 129.7 g/L (95% Confidence Interval (CI), 128.51; 130.88) and 777.33 ng/mL (95% CI, 701.33; 852.77), respectively. Hemoglobin levels were lower with older age, higher percentage of subjects with diabetes, hypertension and overall comorbidities, and admitted to intensive care. Ferritin level increased with older age, increasing proportion of hypertensive study participants, and increasing proportion of mortality. Compared to moderate cases, severe COVID-19 cases had lower hemoglobin [weighted mean difference (WMD), - 4.08 g/L (95% CI - 5.12; - 3.05)] and red blood cell count [WMD, - 0.16 × 1012 /L (95% CI - 0.31; - 0.014)], and higher ferritin [WMD, - 473.25 ng/mL (95% CI 382.52; 563.98)] and red cell distribution width [WMD, 1.82% (95% CI 0.10; 3.55)]. A significant difference in mean ferritin levels of 606.37 ng/mL (95% CI 461.86; 750.88) was found between survivors and non-survivors, but not in hemoglobin levels. Future studies should explore the impact of iron metabolism and anemia in the pathophysiology, prognosis, and treatment of COVID-19.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Coronavirus Infections / Coronavirus / Pandemics / Anemia / Iron Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study / Reviews / Systematic review/Meta Analysis Limits: Humans Language: English Journal: Eur J Epidemiol Journal subject: Epidemiology Year: 2020 Document Type: Article Affiliation country: S10654-020-00678-5

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Coronavirus Infections / Coronavirus / Pandemics / Anemia / Iron Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study / Reviews / Systematic review/Meta Analysis Limits: Humans Language: English Journal: Eur J Epidemiol Journal subject: Epidemiology Year: 2020 Document Type: Article Affiliation country: S10654-020-00678-5