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The U-shaped association of serum iron level with COVID-19 severity: Is iron a potential therapeutic target?
Kentaro Tojo; Yoh Sugawara; Yasufumi Oi; Fumihiro Ogawa; Takuma Higurashi; Yukihiro Yoshimura; Nobuyuki Miyata; Hajime Hayami; Yoshikazu Yamaguchi; Yoko Ishikawa; Ichiro Takeuchi; Natsuo Tachikawa; Takahisa Goto.
  • Kentaro Tojo; Yokohama City University School of Medicine
  • Yoh Sugawara; Yokohama Municipal Citizen's Hospital
  • Yasufumi Oi; Yokohama City University School of Medicine
  • Fumihiro Ogawa; Yokohama City University School of Medicine
  • Takuma Higurashi; Yokohama City University School of Medicine
  • Yukihiro Yoshimura; Yokohama Municipal Citizen's Hospital
  • Nobuyuki Miyata; Yokohama Municipal Citizen's Hospital
  • Hajime Hayami; Yokohama Municipal Citizen's Hospital
  • Yoshikazu Yamaguchi; Yokohama Municipal Citizen's Hospital
  • Yoko Ishikawa; Yokohama City University School of Medicine
  • Ichiro Takeuchi; Yokohama City University School of Medicine
  • Natsuo Tachikawa; Yokohama Municipal Citizen's Hospital
  • Takahisa Goto; Yokohama City University School of Medicine
Preprint in English | medRxiv | ID: ppmedrxiv-21252061
ABSTRACT
Coronavirus disease 2019 (COVID-19) is an emerging infectious disease that leads to severe respiratory failure (RF). It is known that host exposure to viral infection triggers an iron-lowering response to mitigate pathogenic load and tissue damage. However, the association between host iron-lowering response and COVID-19 severity is not clear. This two-center observational study of 136 adult hospitalized COVID-19 patients analyzed the association between disease severity and initial serum iron, total iron-binding capacity (TIBC), and transferrin saturation (TSAT) levels. Serum iron levels were significantly lower in patients with mild RF than in the non-RF group; however, there were no significant differences in iron levels between the non-RF and severe RF groups, depicting a U-shaped association between serum iron levels and disease severity. TIBC levels decreased significantly with increasing severity; consequently, TSAT was significantly higher in patients with severe RF than in other patients. Multivariate analysis including only patients with RF adjusted for age and sex demonstrated that higher serum iron and TSAT levels were independently associated with the development of severe RF, indicating that inadequate response to lower serum iron might be an exacerbating factor for COVID-19.
Full text: Available Collection: Preprints Database: medRxiv Type of study: Randomized controlled trials / Risk factors Language: English Year: 2021 Document Type: Preprint

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Full text: Available Collection: Preprints Database: medRxiv Type of study: Randomized controlled trials / Risk factors Language: English Year: 2021 Document Type: Preprint