TY - JOUR

T1 - Biomarkers for iron metabolism among patients hospitalized with community-acquired pneumonia caused by infection with SARS-CoV-2, bacteria, and influenza

AU - Hegelund, Maria Hein

AU - Glenthøj, Andreas

AU - Ryrsø, Camilla Koch

AU - Ritz, Christian

AU - Dungu, Arnold Matovu

AU - Sejdic, Adin

AU - List, Karoline Cecilie Knudsen

AU - Krogh-Madsen, Rikke

AU - Lindegaard, Birgitte

AU - Kurtzhals, Jørgen Anders Lindholm

AU - Faurholt-Jepsen, Daniel

N1 - This article is protected by copyright. All rights reserved.

PY - 2022

Y1 - 2022

N2 - Background: Ferritin, the central iron storage protein, has attracted attention as a biomarker of severe COVID-19. Few studies have investigated regulators of iron metabolism in the context of COVID-19. The aim was to evaluate biomarkers for iron metabolism in the acute phase response to community-acquired pneumonia (CAP) caused by SARS-CoV-2 compared to CAP caused by bacteria or influenza virus in hospitalized patients.Methods: A cross-sectional study of 164 patients from the Surviving Pneumonia Cohort recruited between January 8, 2019 and May 26, 2020. Blood samples were collected at admission and analyzed for levels of C-reactive protein (CRP), ferritin, soluble transferrin receptor, erythroferrone, and hepcidin.Results: Median (IQR) hepcidin was higher in SARS-CoV-2 with 143.8 (100.7-180.7) ng/mL compared to bacterial and influenza infection with 78.8 (40.1-125.4) and 53.5 (25.2-125.8) ng/mL, respectively. The median ferritin level was more than 2-fold higher in patients with SARS-CoV-2 compared to the other etiologies (p<0.001). Patients with SARS-CoV-2 had lower levels of erythroferrone and CRP compared to those infected with bacteria.Conclusion: Higher levels of hepcidin and lower levels of erythroferrone despite lower CRP levels among patients with SARS-CoV-2 compared to those infected with bacteria indicate alterations in iron metabolism in patients with SARS-CoV-2 infection.

AB - Background: Ferritin, the central iron storage protein, has attracted attention as a biomarker of severe COVID-19. Few studies have investigated regulators of iron metabolism in the context of COVID-19. The aim was to evaluate biomarkers for iron metabolism in the acute phase response to community-acquired pneumonia (CAP) caused by SARS-CoV-2 compared to CAP caused by bacteria or influenza virus in hospitalized patients.Methods: A cross-sectional study of 164 patients from the Surviving Pneumonia Cohort recruited between January 8, 2019 and May 26, 2020. Blood samples were collected at admission and analyzed for levels of C-reactive protein (CRP), ferritin, soluble transferrin receptor, erythroferrone, and hepcidin.Results: Median (IQR) hepcidin was higher in SARS-CoV-2 with 143.8 (100.7-180.7) ng/mL compared to bacterial and influenza infection with 78.8 (40.1-125.4) and 53.5 (25.2-125.8) ng/mL, respectively. The median ferritin level was more than 2-fold higher in patients with SARS-CoV-2 compared to the other etiologies (p<0.001). Patients with SARS-CoV-2 had lower levels of erythroferrone and CRP compared to those infected with bacteria.Conclusion: Higher levels of hepcidin and lower levels of erythroferrone despite lower CRP levels among patients with SARS-CoV-2 compared to those infected with bacteria indicate alterations in iron metabolism in patients with SARS-CoV-2 infection.

KW - Faculty of Science

KW - COVID-19

KW - Community-acquired pneumonia

KW - Iron metabolism

KW - Hepcidin

KW - Ferritin

KW - Erythroferrone

KW - Biomarkers

U2 - 10.1111/apm.13259

DO - 10.1111/apm.13259

M3 - Journal article

C2 - 35751642

VL - 130

SP - 590

EP - 596

JO - A P M I S. Acta Pathologica, Microbiologica et Immunologica Scandinavica

JF - A P M I S. Acta Pathologica, Microbiologica et Immunologica Scandinavica

SN - 0903-4641

IS - 9

ER -