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Current Respiratory Medicine Reviews

Editor-in-Chief

ISSN (Print): 1573-398X
ISSN (Online): 1875-6387

Research Article

Iron Dysregulation: Unveiling Predictive Biomarkers for Severity in COVID-19 Patients

Author(s): Zahra Shaghaghi, Seyyed Hamid Hashemi, Maryam Alvandi*, Zeynab Marzhoseyni, Hamidreza Ghasemi-Basir, Tayeb Mohamadi and Soghra Farzipour

Volume 21, Issue 3, 2025

Published on: 29 August, 2024

Page: [218 - 226] Pages: 9

DOI: 10.2174/011573398X306178240816054525

Price: $65

Abstract

Objective: This study aimed to elucidate the association between iron dysregulation and the severity of COVID-19, examining serum levels of iron-related biomarkers in hospitalized patients. The primary objective was to identify reliable predictors for disease severity, specifically focusing on the role of ferritin, Hemoglobin (Hb), Total Iron-binding Capacity (TIBC), and iron.

Materials and Methods: The study enrolled 117 consecutive COVID-19 patients, classified into mild, severe, and critical groups. Serum levels of Hb, TIBC, iron, and ferritin were measured using standardized methods. Data were analyzed using ROC analysis, logistic regression models, and correlation assessments. The study adhered to ethical guidelines, obtaining informed consent from all participants.

Results: Results revealed a consistent elevation in iron and ferritin levels as disease severity increased, accompanied by a reciprocal decline in Hb and TIBC. Ferritin emerged as a robust predictor for disease prognosis, with an AUC of 0.808, providing a sensitivity of 62.50% and a specificity of 91.74%. Age and education were identified as exacerbating factors influencing patient outcomes. The findings have been found to align with previous studies linking higher ferritin levels to adverse outcomes, supporting ferritin’s utility as a prognostic marker.

Conclusion: The intricate relationship between iron metabolism and COVID-19 severity has been highlighted in this study, emphasizing elevated ferritin levels as potential predictors for severe outcomes and indicators of inflammation-induced cellular damage. These findings may contribute valuable insights into personalized patient management strategies and the potential for targeted interventions in severe COVID-19 cases. Further research involving larger populations is essential to validate these observations and enhance our understanding of the complex host response to SARS-CoV-2.

Keywords: COVID-19, iron metabolism, ferritin, Hb, severe acute respiratory syndrome coronavirus, total iron-binding capacity.


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