scholarly journals Iron related biomarkers predict disease severity in a cohort of Portuguese adult patients during COVID-19 acute infection

2021 ◽  
Author(s):  
Ana C. Moreira ◽  
Maria Jose Teles ◽  
Tania Silva ◽  
Clara M. Bento ◽  
Ines Simoes Alves ◽  
...  
Keyword(s):  
Disease Severity ◽  
Iron Metabolism ◽  
Serum Iron ◽  
Demographic Data ◽  
Acute Infection ◽  
Northern Region ◽  
Monocyte Chemoattractant Protein 1 ◽  
Inflammatory Parameters ◽  
Clinical Pictures ◽  
Worse Prognosis

BACKGROUND: Growing evidence indicates a link between iron metabolism and COVID-19 clinical progression, supporting the use of iron and inflammatory parameters as relevant biomarkers to predict patients' outcomes. METHODS: We evaluated iron metabolism and immune response in 303 patients admitted to the main hospital of the northern region of Portugal with variable clinical pictures, from September to November 2020. Of these, 127 tested positive for SARS-CoV-2 and 176 tested negative. Iron-related laboratory parameters and cytokines were determined in blood samples collected soon after admission and, in a subgroup of patients, throughout hospitalization. Demographic data, comorbidities and clinical outcomes were recorded. Patients were assigned into 5 groups according to disease severity. RESULTS: Serum iron and transferrin levels at admission were lower in COVID-19-positive than in COVID-19-negative patients. Conversely, the levels of interleukin(IL)-6 and monocyte chemoattractant protein 1 (MCP1) were increased in COVID-19-positive patients. The lowest serum iron and transferrin levels at diagnosis were associated with the worst outcomes. Iron levels negatively correlated with IL-6 and higher levels of this cytokine were associated with a worse prognosis. Serum ferritin levels at diagnosis were higher in COVID-19-positive than in COVID-19-negative patients but did not correlate with disease severity. Longitudinal determinations of iron and ferritin made in a subgroup of patients (n=23) revealed highly variable results. CONCLUSIONS: Serum iron is the simplest laboratory test to be implemented as a predictor of disease progression in hospitalized acute COVID-19-positive patients. Variation of ferritin with time should be revisited in larger cohorts.

scholarly journals Iron Related Biomarkers Predict Disease Severity in a Cohort of Portuguese Adult Patients during COVID-19 Acute Infection

Viruses ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2482
Author(s):  
Ana C. Moreira ◽  
Maria Jose Teles ◽  
Tânia Silva ◽  
Clara M. Bento ◽  
Inês Simões Alves ◽  
...  
Keyword(s):  
Serum Iron ◽  
Demographic Data ◽  
Acute Infection ◽  
Northern Region ◽  
Clinical Progression ◽  
Large Variability ◽  
Monocyte Chemoattractant Protein 1 ◽  
Monocyte Chemoattractant ◽  
Clinical Pictures ◽  
Worse Prognosis

Large variability in COVID-19 clinical progression urges the need to find the most relevant biomarkers to predict patients’ outcomes. We evaluated iron metabolism and immune response in 303 patients admitted to the main hospital of the northern region of Portugal with variable clinical pictures, from September to November 2020. One hundred and twenty-seven tested positive for SARS-CoV-2 and 176 tested negative. Iron-related laboratory parameters and cytokines were determined in blood samples collected soon after admission. Demographic data, comorbidities and clinical outcomes were recorded. Patients were assigned into five groups according to severity. Serum iron and transferrin levels at admission were lower in COVID-19-positive than in COVID-19-negative patients. The levels of interleukin (IL)-6 and monocyte chemoattractant protein 1 (MCP-1) were increased in COVID-19-positive patients. The lowest serum iron and transferrin levels at diagnosis were associated with the worst outcomes. Iron levels negatively correlated with IL-6 and higher levels of this cytokine were associated with a worse prognosis. Serum ferritin levels at diagnosis were higher in COVID-19-positive than in COVID-19-negative patients. Serum iron is the simplest laboratory test to be implemented as a predictor of disease progression in COVID-19-positive patients.

scholarly journals Hypoferremia predicts hospitalization and oxygen demand in COVID-19 patients

2020 ◽  
Author(s):  
Theresa Hippchen ◽  
Sandro Altamura ◽  
Martina U. Muckenthaler ◽  
Uta Merle
Keyword(s):  
Iron Metabolism ◽  
Serum Iron ◽  
Iron Concentration ◽  
Oxygen Demand ◽  
Multivariate Regression Analysis ◽  
High Oxygen ◽  
University Hospital ◽  
List Type ◽  
Inflammatory Parameters ◽  
High Oxygen Demand

ABSTRACTBackgroundIron metabolism might play a crucial role in cytokine release syndrome in COVID-19 patients. Therefore we assessed iron metabolism markers in COVID-19 patients for their ability to predict disease severity.MethodsCOVID-19 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).ResultsIron metabolism parameters were severely altered in patients of cohort B and C compared to cohort A. In multivariate regression analysis including age, gender, CRP 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 <6µmol/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, procalcitonin, and CRP. Unexpectedly, serum iron levels poorly correlate with hepcidin.ConclusionWe conclude that measurement of serum iron can help predicting the severity of COVID-19. 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.KEY POINTSIron metabolism parameters are severely altered in COVID-19 patients.Measurement of serum iron can help predicting the severity of COVID-19.

Efficacy and safety of drospirenone-containing microdosage combined oral contraceptive use with starting contraception

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (2) ◽  
pp. 9-13
Author(s):  
A R Khachaturian ◽  
E V Misharina ◽  
M I Yarmolinskaya
Keyword(s):  
Blood Pressure ◽  
Body Weight ◽  
Oral Contraceptive ◽  
Waist Circumference ◽  
Young Women ◽  
Iron Metabolism ◽  
Serum Iron ◽  
The Body ◽  
Menstrual Bleeding ◽  
Combined Oral Contraceptive

Androgen-dependent dermopathy, as well as premenstrual syndrome of varying severity in young women, can cause emotional depression, difficulties in social adaptation and even depressive disorders. The aim of the study was to study the safety and efficacy of using a combined oral contraceptive (COC) Dimia® containing 20 μg ethinyl estradiol and 3 mg drospirenone in young women, as well as its therapeutic effects in androgen-dependent dermopathy. Materials and methods. The study included 57 young women aged 23.1±2.2 years with signs of androgen-dependent dermopathy. The evaluation of the change in the character of menstrual bleeding, the anthropometric parameters (body weight, waist circumference and hips), the therapeutic effect of the drug on the symptoms of androgen-dependent dermopathy, as well as the dynamics of arterial pressure, hemoglobin level, serum iron have been studied. The psycho-emotional state was assessed using the SAN questionnaire (well-being-activity-mood). Results. During 6 months of observation, there was no significant change in the body mass index, waist circumference, and hips, and the drug did not affect the blood pressure numbers. Against the background of taking the drug, there was an increase in the parameters of iron metabolism (hemoglobin content, serum iron). After 3 months of taking the contraceptive with drospirenone, the number of patients with a complaint about the abundance of menstruation decreased more than twofold (from 22.8 to 10.5%), and after 6 months of taking the drug no patient noted the profuse nature of menstruation. Before the start of taking COC with drospirenone, 57.9% of women reported painful menstrual bleeding. Against the background of taking the contraceptive within 3 months, this complaint was stopped in all patients. Sufficient efficacy of treatment of androgen dependent dermopathy in young women with the help of a microdosed drospirenone-containing combined oral contraceptive is estimated from the dermatological acne index. The analysis of the SAN questionnaire made it possible to reveal the improvement in the psychoemotional state of patients on the background of taking the drug. The conclusion. The results obtained proved the effectiveness and safety of the microclinized COC Dimia®. The drug has no significant effect on body weight, blood pressure, provides reliable control of the cycle and a decrease in menstrual bleeding, which results in stabilization of iron metabolism in the body. Dimia® is effective in the treatment of androgen-dependent dermopathy and can be recommended to young women for starting contraception.

Combination Therapies for Hidradenitis Suppurativa: A Retrospective Chart Review of 31 Patients

2019 ◽  
Vol 23 (3) ◽  
pp. 270-276 ◽  
Author(s):  
Meghan L. McPhie ◽  
Alanna C. Bridgman ◽  
Mark G. Kirchhof
Keyword(s):  
Disease Severity ◽  
Hidradenitis Suppurativa ◽  
Chart Review ◽  
Small Sample Size ◽  
Demographic Data ◽  
Severe Disease ◽  
Treatment Protocol ◽  
Retrospective Chart Review ◽  
Small Sample ◽  
Combination Therapies

Background: Although a variety of medical and surgical interventions exist for the treatment of hidradenitis suppurativa (HS), it remains a challenging disease to manage because of its variable presentation and unpredictable clinical course. Apart from the combination of clindamycin and rifampin, the success of other combination therapies is largely unknown. Objectives: The goal of our study was to examine the clinical utility of various combination therapies for the treatment of HS. Methods: We conducted a qualitative retrospective chart review of 31 patients with dermatologist-diagnosed HS who were seen at an academic teaching hospital between 2014 and 2018. Demographic data, disease location, disease severity, and treatment protocol were retrieved for analysis. Hurley stage was used to classify disease severity on initial presentation, and the International Hidradenitis Suppurativa Severity Score System (IHS4) was used to track changes across visits. Results: Of the 31 patients (Mage = 37.7 years; 67.7% female) included in the study, 6 (19.4%), 11 (35.5%), and 14 (45.2%) patients were classified as Hurley stages I, II, and III, respectively. Although no statistical results are provided because of the small sample size, we have identified several drug combinations that show promising clinical response for patients with HS based on their IHS4 score, such as isotretinoin/spironolactone for mild disease, isotretinoin or doxycycline with adalimumab for moderate disease, and cyclosporine/adalimumab for severe disease. Conclusions: This preliminary work demonstrates that HS treatment with combination therapy appears to be a promising method of disease management.

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 Impact of thermogenesis induced by chronic β3-adrenergic receptor agonist treatment on inflammatory and infectious response during bacteremia in mice

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256768
Author(s):  
Patrick Munro ◽  
Samah Rekima ◽  
Agnès Loubat ◽  
Christophe Duranton ◽  
Didier F. Pisani ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
White Adipose Tissue ◽  
Adrenergic Receptor ◽  
Receptor Agonist ◽  
Acute Infection ◽  
Immunomodulatory Activity ◽  
Inflammatory Parameters ◽  
Brown Adipose ◽  
Thermogenic Adipocytes ◽  
Adrenergic Receptor Agonist

White adipocytes store energy differently than brown and brite adipocytes which dissipate energy under the form of heat. Studies have shown that adipocytes are able to respond to bacteria thanks to the presence of Toll-like receptors at their surface. Despite this, little is known about the involvement of each class of adipocytes in the infectious response. We treated mice for one week with a β3-adrenergic receptor agonist to induce activation of brown adipose tissue and brite adipocytes within white adipose tissue. Mice were then injected intraperitoneally with E. coli to generate acute infection. The metabolic, infectious and inflammatory parameters of the mice were analysed during 48 hours after infection. Our results shown that in response to bacteria, thermogenic activity promoted a discrete and local anti-inflammatory environment in white adipose tissue characterized by the increase of the IL-1RA secretion. More generally, activation of brown and brite adipocytes did not modify the host response to infection including no additive effect with fever and an equivalent bacteria clearance and inflammatory response. In conclusion, these results suggest an IL-1RA-mediated immunomodulatory activity of thermogenic adipocytes in response to acute bacterial infection and open a way to characterize their effect along more chronic infection as septicaemia.

CNS Inflammation Induced by Lipopolysaccharide Up-Regulates Hepatic Hepcidin Expression by Activating IL-6/JAK2/STAT3 Pathway in Mice

2020 ◽  
Author(s):  
fali zhang ◽  
peng zhao ◽  
zhongming Qian ◽  
mingkang zhong
Keyword(s):  
Protein Expression ◽  
Iron Metabolism ◽  
Serum Iron ◽  
Transferrin Saturation ◽  
Cns Inflammation ◽  
Inflammation Response ◽  
Stat3 Pathway ◽  
Hepcidin Expression ◽  
Mrna And Protein Expression ◽  
The Brain

Abstract BackgroundLPS triggers inflammation response in periphery, whether the infection in CNS induced by LPS ICV injection affected the peripheral iron metabolism was unknown , The current study was to find out whether LPS injected to the brain could regulate hepcidin expression in liver and peripheral iron metabolism. MethodsWide type mice (IL-6+/+) and IL-6-/- mice of 8-week-old were performed on ICV injection with LPS. After 6h, hepcidin expression in liver, as well as serum iron and transferrin saturation was detected and calculated, we also tested the IL-6/JAK2/STAT3 pathway in hepcidin regulation in liver of IL-6 knockout (IL-6-/- mice) and IL-6+/+ mice, AG490 as an inhibitor of JAK2 was used to confirm the effect of IL-6/JAK2/STAT3 pathway on hepcidin expression in liver. ResultsHepcidin mRNA, IL-6 mRNA and protein expression in the liver of IL-6-/- mice was significantly lower than IL-6+/+ mice after LPS administration. IL-6 deficiency abolished the decrease of serum iron, transferrin saturation induced by LPS injection. IL-6 deficiency also abolished the decrease of Fpn1, increase of pSTAT3 and Ft-L protein in liver. AG490 significantly reduced the pSTAT3 protein and abolished the changes of Fpn1 and Ft-L expression induced by LPS in liver. ConclusionThese finding provided further evidence that the effect of central inflammation on the hepatic hepcidin expression and peripheral iron metabolism.

scholarly journals Model of reticuloendothelial iron metabolism in humans: abnormal behavior in idiopathic hemochromatosis and in inflammation

Blood ◽  
1989 ◽  
Vol 74 (2) ◽  
pp. 844-851 ◽  
Author(s):  
G Fillet ◽  
Y Beguin ◽  
L Baldelli
Keyword(s):  
Iron Metabolism ◽  
Serum Iron ◽  
Normal Subjects ◽  
Heme Iron ◽  
Rate Of Change ◽  
Abnormal Behavior ◽  
Early Release ◽  
Iron Stores ◽  
Idiopathic Hemochromatosis

Abstract Iron transport in the reticuloendothelial (RE) system plays a central role in iron metabolism, but its regulation has not been characterized physiologically in vivo in humans. In particular, why serum iron is elevated and RE cells are much less iron-loaded than parenchymal cells in idiopathic hemochromatosis is not known. The processing of erythrocyte iron by the RE system was studied after intravenous (IV) injection of 59Fe heat-damaged RBCs (HDRBCs) and 55Fe transferrin in normal subjects and in patients with iron deficiency, idiopathic hemochromatosis, inflammation, marrow aplasia, or hyperplastic erythropoiesis. Early release of 59Fe by the RE system was calculated from the plasma iron turnover and the 59Fe plasma reappearance curve. Late release was calculated from the ratio of 59Fe/55Fe RBC utilization in 2 weeks. The partitioning of iron between the early (release from heme catabolism) and late (release from RE stores) phases depended on the size of RE iron stores, as illustrated by the inverse relationship observed between early release and plasma ferritin (P less than .001). There was a strong correlation between early release and the rate of change of serum iron levels during the first three hours in normal subjects (r = .85, P less than .001). Inflammation produced a blockade of the early release phase, whereas in idiopathic hemochromatosis early release was considerably increased as compared with subjects with similar iron stores. Based on these results, we describe a model of RE iron metabolism in humans. We conclude that the RE system appears to determine the diurnal fluctuations in serum iron levels through variations in the immediate output of heme iron. In idiopathic hemochromatosis, a defect of the RE cell in withholding iron freed from hemoglobin could be responsible for the high serum iron levels and low RE iron stores.

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