scholarly journals The U-shaped association of serum iron level with COVID-19 severity: Is iron a potential therapeutic target?

2021 ◽  
Author(s):  
Kentaro Tojo ◽  
Yoh Sugawara ◽  
Yasufumi Oi ◽  
Fumihiro Ogawa ◽  
Takuma Higurashi ◽  
...  
Keyword(s):  
Disease Severity ◽  
Serum Iron ◽  
Binding Capacity ◽  
Transferrin Saturation ◽  
University Hospital ◽  
Iron Level ◽  
Inadequate Response ◽  
Serum Iron Level ◽  
Median Serum ◽  
Iron Binding Capacity

AbstractObjectiveTo evaluate the association between iron metabolism indicators and disease severity in hospitalized patients with coronavirus disease 2019 (COVID-19).DesignTwo-center observational studySettingA university hospital and a core hospital in Yokohama, JapanPatientsAdults with COVID-19 whose serum iron levels were measured within the first 5 days of hospitalization were included. Patients who refused mechanical ventilation were excluded from the study.Measurements and Main ResultsOne hundred thirty-six patients were included in this study. We analyzed the association between COVID-19 severity and serum iron, total iron binding capacity (TIBC), and transferrin saturation (TSAT) levels. Disease severity was defined as the worst respiratory status during hospitalization. Serum iron levels were significantly lower in patients with mild respiratory failure (RF) (n=55, median serum iron level: 24 [interquartile range: 19–42] mg/dL) than in the non-RF group (n=44, 40 [24–80] mg/dL) and the severe RF group (n=37, 60 [23.5–87] mg/dL); however, there were no significant differences in iron levels between the non-RF and severe RF groups (non-RF vs. mild RF: p=0.019, non-RF vs. severe RF: p>0.999, and mild RF vs. severe RF: p=0.009). That is, there was 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 or TSAT levels were independently associated with development of severe RF.ConclusionsA U-shaped association between serum iron level and RF severity in hospitalized COVID-19 patients was observed. Higher serum iron levels in COVID-19 patients with RF are associated with the development of severe RF, indicating that inadequate response to lower serum iron might be an exacerbating factor for COVID-19.

scholarly journals The U-shaped association of serum iron level with disease severity in adult hospitalized patients with COVID-19

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kentaro Tojo ◽  
Yoh Sugawara ◽  
Yasufumi Oi ◽  
Fumihiro Ogawa ◽  
Takuma Higurashi ◽  
...  
Keyword(s):  
Disease Severity ◽  
Serum Iron ◽  
Binding Capacity ◽  
Transferrin Saturation ◽  
Total Iron ◽  
Iron Level ◽  
Inadequate Response ◽  
Lower Serum ◽  
Serum Iron Level ◽  
Iron Binding Capacity

AbstractCoronavirus 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.

Influence of hepcidin on iron homeostasis during last trimester of gestation in Bos indicus (cattle)

2019 ◽  
Author(s):  
K. Rajamanickam ◽  
M. Sameer Ali ◽  
V. Leela
Keyword(s):  
Serum Iron ◽  
Iron Homeostasis ◽  
Binding Capacity ◽  
Colorimetric Method ◽  
Maternal Serum ◽  
Iron Bioavailability ◽  
Iron Level ◽  
Iron Binding ◽  
Serum Iron Level ◽  
Iron Binding Capacity

Hepcidin is an important hormone regulating the systemic iron bio-availability. Blood samples were collected from thirty pregnant cattle during their last trimester of pregnancy to assess the relation of hepcidin to iron homeostasis. Serum hepcidin level was quantified using ELISA and serum iron, transferrin iron binding capacity and unsaturated iron binding capacity were estimated by colorimetric method. Correlation between hepcidin and other iron related parameters was assessed. Dependency of serum iron level on hepcidin was also determined by regression method. It was revealed that hepcidin was negatively correlated to serum iron and transferrin iron binding capacity (p less than 0.001) and also hepcidin has highest predictive value on serum iron level and transferrin iron binding capacity (p less than 0.001). It can be concluded that during pregnancy increase in hepcidin reduces the maternal serum iron and also it is a biomarker for iron bioavailability to the developing fetus.

Evaluation of serum iron and iron binding capacity in cows with paratuberculosis

2009 ◽  
Vol 37 (06) ◽  
pp. 375-378 ◽  
Author(s):  
Z. Metcitoglu ◽  
M. Ulgen ◽  
E. Borum ◽  
E. Temizel ◽  
S. Kasap ◽  
...  
Keyword(s):  
Microscopic Examination ◽  
Serum Iron ◽  
Binding Capacity ◽  
Control Group ◽  
Iron Level ◽  
Iron Binding ◽  
Serum Iron Level ◽  
Haematological Values ◽  
Mycobacterium Avium Subsp Paratuberculosis ◽  
Iron Binding Capacity

Summary Objective: The purpose of the study was to evaluate the results of routine haematological, serum iron and iron binding capacity analyses in cattle with Mycobacterium avium subsp. paratuberculosis (MAP) infection. Material and methods: Thirty-eight cows were included in the study. An ELISA for MAP, intradermal Johnin test and microscopic examination of the animals faecal smears for acid fast organisms were performed. According to the results 19 cows (4–8 years old) were found positive and 19 cows (4–7 years old) from the same herd were negative and served as control group. In all cows routine haematological values as well as serum iron level and iron binding capacity were evaluated. Results: When compared with control animals, routine haematological values including haematocrit, haemoglobin and erythrocyte counts were significantly (p < 0.05) lower in positive cows. Also serum iron level (p < 0.01) and iron binding capacity (p < 0.01) were significantly lower in positive cows than in the control group. Conclusion: As a result, these parameters can be important for the mechanism of the pathogenesis of paratuberculosis.

scholarly journals Lymphocyte labile iron pool, plasma iron, transferrin saturation and ferritin levels in colon cancer patients.

2002 ◽  
Vol 49 (1) ◽  
pp. 269-272 ◽  
Author(s):  
Daniel Gackowski ◽  
Marcin Kruszewsk ◽  
Zbigniew Banaszkiewicz ◽  
Arkadiusz Jawien ◽  
Ryszard Olinski
Keyword(s):  
Binding Capacity ◽  
Transferrin Saturation ◽  
Control Group ◽  
Iron Level ◽  
Iron Availability ◽  
Serum Iron Level ◽  
Labile Iron Pool ◽  
Labile Iron ◽  
Iron Pool ◽  
Iron Binding Capacity

Patients with colorectal carcinoma showed statistically significant lower values of transferrin saturation, total iron binding capacity and serum iron level as compared with control group, while the level of ferritin and the size of labile iron pool in carcinoma patients were higher, although this difference was not statistically significant. Our observations are in favour of the hypothesis which suggests that changes in iron metabolism restrict iron availability for tumour cells and as consequence, slow their growth.

scholarly journals Author Correction: The U‑shaped association of serum iron level with disease severity in adult hospitalized patients with COVID‑19

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kentaro Tojo ◽  
Yoh Sugawara ◽  
Yasufumi Oi ◽  
Fumihiro Ogawa ◽  
Takuma Higurashi ◽  
...  
Keyword(s):  
Disease Severity ◽  
Serum Iron ◽  
Hospitalized Patients ◽  
Iron Level ◽  
Serum Iron Level

scholarly journals Iron serum levels and iron homeostasis parameters in patients with nosocomial pneumonia treated with cefiderocol: post hoc analysis of the APEKS-NP study

2022 ◽  
Author(s):  
Eric P. Skaar ◽  
Roger Echols ◽  
Yuko Matsunaga ◽  
Anju Menon ◽  
Simon Portsmouth
Keyword(s):  
Nosocomial Pneumonia ◽  
Serum Iron ◽  
Iron Homeostasis ◽  
Binding Capacity ◽  
Transferrin Saturation ◽  
Efficacy And Safety ◽  
Baseline Serum ◽  
Post Hoc Analysis ◽  
Iron Binding Capacity ◽  
Post Hoc

AbstractCritically ill patients often present with low serum iron levels or anemia. We evaluated the impact of iron levels and iron homeostasis on the efficacy and safety of cefiderocol, an iron-chelator siderophore cephalosporin, in patients with nosocomial pneumonia in a post hoc analysis of the randomized, double-blind, Phase 3 APEKS-NP study (NCT03032380). Patients with Gram-negative nosocomial pneumonia received cefiderocol 2 g, 3-h infusion, q8h, or high-dose, extended-infusion meropenem 2 g, 3-h infusion, q8h, for 7–14 days. Efficacy and safety parameters, including specific iron homeostasis parameters (i.e., hepcidin, iron, total iron binding capacity, transferrin saturation), were analyzed according to baseline iron levels. In the cefiderocol and meropenem arms, 79.1% (117/148) and 83.3% (125/150) randomized patients, respectively, had low baseline serum iron levels. Rates of 14-day (12.3% [14/114] vs 11.6% [14/121]) and 28-day all-cause mortality (20.5% [23/112] vs 19.0% [23/121]), clinical cure (63.2% [72/114] vs 67.2% [82/122]), and microbiological eradication (43.6% [41/94] vs 48.1% [51/106]) at test of cure were similar in cefiderocol vs meropenem arms, respectively. In the overall safety population, rates of anemia-related adverse events were similar (cefiderocol arm 18.2% [27/148], meropenem arm 18.7% [28/150]). Changes from baseline to test of cure in hepcidin, iron, total iron binding capacity, and transferrin saturation were similar between treatment arms. Cefiderocol treatment did not affect iron homeostasis, and its efficacy and safety were not influenced by baseline serum iron levels. Clinicaltrials.gov registration: NCT03032380. Date of registration: 26 January 2017.

Serum iron and total iron-binding capacity compared with serum ferritin in assessment of iron deficiency.

1981 ◽  
Vol 27 (2) ◽  
pp. 276-279 ◽  
Author(s):  
F Peter ◽  
S Wang
Keyword(s):  
Iron Deficiency ◽  
Serum Ferritin ◽  
Serum Iron ◽  
Binding Capacity ◽  
Transferrin Saturation ◽  
Total Iron ◽  
Iron Binding ◽  
Total Iron Binding Capacity ◽  
Iron Deficient ◽  
Iron Binding Capacity

Abstract Ferritin values for 250 selected sera were compared with values for iron, total iron-binding capacity (TIBC), and transferrin saturation, to assess the potential of the ferritin assay for the detection of latent iron deficiency. The specimens were grouped (50 in each group) according to their values for iron and TIBC. In Group 1 (low iron, high TIBC) the saturation and ferritin values both indicated iron deficiency in all but one. In the 100 specimens of Groups 2 (normal iron, high TIBC) and 4 (normal iron, high normal TIBC), the saturation values revealed 16 iron-deficient cases, the ferritin test 55. For Groups 3 (low iron, normal TIBC) and 5 (low iron, low TIBC), the ferritin test revealed fewer cases of iron deficiency than did the saturation values (37 cases vs 51 cases, in the 100 specimens). Evidently the ferritin test detects iron deficiency in many cases for whom the serum iron and TIBC tests are not positively indicative. The correlation of serum ferritin with iron, TIBC, and transferrin saturation in the five groups was good only in the case of specimens for which the TIBC was normal; if it was abnormal the correlation was very poor.

scholarly journals Iron Status in Malnourished Children : A Cross Sectional Study

2014 ◽  
Vol 13 (3) ◽  
pp. 50-53
Author(s):  
Shormin Ara Ferdousi ◽  
Rajat Sanker Roy Biswas ◽  
Nayan Kanti Paul ◽  
Mohammed Rezaul Karim
Keyword(s):  
Serum Iron ◽  
Iron Status ◽  
Transferrin Saturation ◽  
Age Groups ◽  
Cross Sectional Study ◽  
Iron Level ◽  
Serum Iron Level ◽  
Cross Sectional ◽  
Malnourished Children ◽  
Different Types

Objectives: Malnutrition is a common condition among children and iron status varies in different types of malnutrition. So the present study is aimed to find the different iron status among severe malnourished children in our context. Methods: A hospital based cross sectional study was done in the Paediatrics ward Chittagong Medical College Hospital in a period of 6 months from January to July 2013 among the 50 cases of malnourished children of age range between 1 to 5 years and Weight for Height Z score(WHZ) was <-2  SD. Sampling technique was continuous purposive sampling. Venous blood was collected to assay the different iron profile mainly serum iron level, total iron binding capacity(TIBC) and transferrin saturation(TSAT). Data was analyzed after correction by SPSS-19. Results: Among the 50 study children of different age groups 15 patients were 1 to 2 years, 18 patients were 2 to 3 years, 10 patients were 3 to 4 years and 7 patients were at 4-5 years of age groups. Among the patients, 29 (58%) of patients were female and 21(42%) of the patients were male. Most of the children were from the families of low socioeconomic status 38(76%). 2(4%) children were from upper middle class who had step mother. Among the selected patients the dominating clinical features were anemia was found among 45(90%) of patients which was mild(66.6%), moderate(26.6%) and severe(6.6%). Skin changes(32%), eye  changes (10%) and hair changes(48%) were also found. Among the 50 study subjects prelacteal feeding was given among 43(86%) children, breast feeding was given 45(90%), exclusive breast feeding was given to 24(48%) of children and complementary feeding after 6 months was given to 29(58%) patients. Among the 50 patients -2 to -3 SD weight for height was found in 20(40%) patients and <-3 SD was found in 30(60%) patients. Most of the children was found to have Mid Upper Arm Circumference (MUAC) 115-125 mm(50%). Iron status was measured among all patients where serum iron level was found 77.72 ± 11.22 mcgm/dl, TIBC was found 340.07 ± 22.67 mcgm/dl and transferrin saturation was found 22.38 ± 2.9 %. Iron status were measured among the different types of malnutrition where serum iron level and transferrin saturation was high among all patients with malnutrition while TIBC was lower than standard level in all patients. Different biochemical status were measured among the different types of malnutrition where serum total protein, serum albumin, Hb% were lower than standard level in all patients.Conclusion: Change in different iron status is a common findings in malnourished children. Screening of all children for anemia and providing iron and folic acid (IFA) or multiple micronutrients (MMN) supplements to children and Infant and Young Child Feeding (IYCF) should be addressed at all level to overcome the situation.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i3.21024

Subclinical Iron Deficiency in Non-Anemic Individuals: A Retrospective Analysis of Korean Health Examinees

2019 ◽  
Vol 143 (1) ◽  
pp. 26-32
Author(s):  
Eun-Hee Nah ◽  
Han-Ik Cho ◽  
Seon Cho ◽  
Suyoung Kim
Keyword(s):  
Iron Deficiency ◽  
Blood Cell ◽  
Serum Iron ◽  
Binding Capacity ◽  
Transferrin Saturation ◽  
Reproductive Age ◽  
Iron Level ◽  
Distribution Width ◽  
Elderly Males ◽  
Males And Females

Objectives: Non-anemic individuals may have undetected subclinical iron deficiency (SID). The aims of this study were to determine the prevalence of SID and identify the associated factors for SID. In addition, the screening performance of red blood cell (RBC) indices for SID in health check-ups was assessed. Methods: This study was conducted with 16,485 non-anemic health examinees (3,567 males and 12,918 females) who underwent tests for iron variables (serum iron, total iron-binding capacity, ferritin, and iron saturation) at 16 health-promotion centers in 13 cities in Korea between January 2017 and June 2018. SID was defined as a decreased ferritin level (<24 µg/L in males and <15 µg/L in females) and either a decreased serum iron level (<44 µg/dL in males and <29 µg/dL in females) or a transferrin saturation of <20%. Results: The prevalence rates of SID were 0.6 and 3.3% in males and females, respectively. In terms of age and sex, SID was most prevalent in males aged ≥70 years (7.8%) and females aged 15–49 years (7.6%). There were significant differences in the hemoglobin (Hb) level, white blood cell count, platelet count, mean corpuscular volume, mean corpuscular Hb (MCH), and RBC distribution width (RDW) between the SID and non-SID groups (p < 0.001). The factors associated with SID in males were older age (odds ratio, OR, 1.069, 95% confidence interval, CI, 1.03–1.109, p = 0.004), lower Hb (OR 0.58, 95% CI 0.345–0.976, p = 0.04), lower MCH (OR 0.433, 95% CI 0.298–0.629, p < 0.001), and higher RDW (OR 1.374, 95% CI 1.001–1.887, p = 0.049), while in females they were lower body mass index (BMI; OR 0.929, 95% CI 0.895–0.963, p < 0.001) and younger age (OR 0.954, 95% CI 0.945–0.963, p < 0.001), as well as lower Hb, lower MCH, and higher RDW. The AUC for the MCH (0.877, 95% CI 0.793–0.960 in males; 0.872, 95% CI 0.853–0.890 in females) indicates that the MCH at cut-offs of 29.2 and 29.3 pg are the best discriminators of SID in males and females, respectively (p < 0.001). Conclusions: Reproductive-age females with a lower BMI and elderly males are high-risk groups for SID. MCH is a reliable RBC index for the screening of SID. For the population with defined risk factors, including females with lower BMI and elderly males, screening for SID is needed to prevent the development of anemia.

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