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SARS-CoV-2 proteins

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    Hypoferremia predicts hospitalization and oxygen demand in COVID-19 MESHD patients

    Authors: Theresa Hippchen; Sandro Altamura; Martina U. Muckenthaler; Uta Merle

    doi:10.1101/2020.06.26.20140525 Date: 2020-06-26 Source: medRxiv

    Background: Iron metabolism might play a crucial role in cytokine release syndrome in COVID-19 MESHD patients. Therefore we assessed iron metabolism markers in COVID-19 MESHD patients for their ability to predict disease severity. Methods: COVID-19 MESHD patients referred to the Heidelberg University Hospital were retrospectively analyzed. Patients were divided into outpatients (cohort A, n=204), inpatients (cohort B, n=81), and outpatients later admitted to hospital because of health deterioration (cohort C, n=23). Results: Iron metabolism parameters were severely altered in patients of cohort B and C compared to cohort A. In multivariate regression analysis including age, gender, CRP HGNC and iron-related parameters only serum iron and ferritin were significantly associated with hospitalization. ROC analysis revealed an AUC for serum iron of 0.894 and an iron concentration <6micromol/l as the best cutoff-point predicting hospitalization with a sensitivity of 94.7% and a specificity of 67.9%. When stratifying inpatients in a low- and high oxygen demand group serum iron levels differed significantly between these two groups and showed a high negative correlation with the inflammatory parameters IL-6 HGNC, procalcitonin, and CRP HGNC. Unexpectedly, serum iron levels poorly correlate with hepcidin HGNC. Conclusion: We conclude that measurement of serum iron can help predicting the severity of COVID-19 MESHD. The differences in serum iron availability observed between the low and high oxygen demand group suggest that disturbed iron metabolism likely plays a causal role in the pathophysiology leading to lung injury MESHD.

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MeSH Disease
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SARS-CoV-2 Proteins


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