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Open AccessEditor’s ChoiceArticle

Prevalence and Predictive Value of Anemia and Dysregulated Iron Homeostasis in Patients with COVID-19 Infection

1
Department of Internal Medicine II, Infectious Disease, Immunology, Rheumatology, Medical University of Innsbruck, 6020 Innsbruck, Austria
2
Department of Internal Medicine, St. Vinzenz Krankenhaus Betriebs GmbH, 6511 Zams, Austria
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(8), 2429; https://doi.org/10.3390/jcm9082429
Received: 25 June 2020 / Revised: 27 July 2020 / Accepted: 28 July 2020 / Published: 29 July 2020
(This article belongs to the Special Issue COVID-19: From Pathophysiology to Clinical Practice)
Infections with SARS-CoV-2 can result in severe clinical manifestations. As such patients present with systemic inflammation, we studied the prevalence and predictive value of anemia of inflammation (AI) or functional iron deficiency (FID), originating from immune-mediated alterations of iron homeostasis. Within this retrospective analysis of 259 hospitalized patients with COVID-19, we found that, upon admission, 24.7% were anemic, with the majority suffering from AI (68.8%). Anemia was associated with a significantly higher in-hospital mortality (OR 3.729 (95%CI 1.739–7.995), p = 0.001) but not an increased frequency of intensive care unit (ICU) admission or need for mechanical ventilation. FID was present in 80.0% of patients upon admission, linked to more advanced inflammation and associated with significantly longer hospital stay. Notably, a ferritin/transferrin ratio > 10 predicted a five-fold higher risk of ICU admission and an eight-fold higher risk of the need for mechanical ventilation. Anemia and alterations of iron homeostasis are highly prevalent in hospitalized COVID-19 patients. Iron metabolism biomarkers and hemoglobin can contribute to risk stratification of patients, as initial anemia is associated with increased mortality, whereas alterations of iron homeostasis with a higher ferritin/transferrin ratio reflect more advanced inflammation and predicts subsequent insufficient pulmonary oxygenation with the need for ICU admission and mechanical ventilation. View Full-Text
Keywords: anemia; iron metabolism; SARS-CoV-2; COVID-19 outcome anemia; iron metabolism; SARS-CoV-2; COVID-19 outcome
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MDPI and ACS Style

Bellmann-Weiler, R.; Lanser, L.; Barket, R.; Rangger, L.; Schapfl, A.; Schaber, M.; Fritsche, G.; Wöll, E.; Weiss, G. Prevalence and Predictive Value of Anemia and Dysregulated Iron Homeostasis in Patients with COVID-19 Infection. J. Clin. Med. 2020, 9, 2429. https://doi.org/10.3390/jcm9082429

AMA Style

Bellmann-Weiler R, Lanser L, Barket R, Rangger L, Schapfl A, Schaber M, Fritsche G, Wöll E, Weiss G. Prevalence and Predictive Value of Anemia and Dysregulated Iron Homeostasis in Patients with COVID-19 Infection. Journal of Clinical Medicine. 2020; 9(8):2429. https://doi.org/10.3390/jcm9082429

Chicago/Turabian Style

Bellmann-Weiler, Rosa; Lanser, Lukas; Barket, Robert; Rangger, Lukas; Schapfl, Anna; Schaber, Marc; Fritsche, Gernot; Wöll, Ewald; Weiss, Günter. 2020. "Prevalence and Predictive Value of Anemia and Dysregulated Iron Homeostasis in Patients with COVID-19 Infection" J. Clin. Med. 9, no. 8: 2429. https://doi.org/10.3390/jcm9082429

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