Severe COVID-19 patients have lower haemoglobin level and red blood cell count and higher ferritin level and red cell distribution

Objectives:
Iron metabolism and anemia may play an important role in multiple organ dysfunction syndrome in Coronavirus disease 2019 (COVID-19). Therefore, this review article has been conducted.

Do biomarkers of anemia and iron metabolism (hemoglobin, ferritin, transferrin, soluble transferrin receptor, hepcidin, haptoglobin, unsaturated iron-binding capacity, erythropoietin, free erythrocyte protoporphyrine and erythrocyte indices) differ in patients diagnosed with COVID-19?

Study design:
This review article included 189 unique studies, with data from 57,563 COVID-19 patients.

Results and conclusions:   
The investigators found pooled mean hemoglobin and ferritin levels in COVID-19 patients across all ages were 129.7 g/L [95% CI = 128.51 to 130.88] and 777.33 ng/mL [95% CI = 701.33 to 852.77], respectively.

The investigators found hemoglobin levels were lower with older age, higher percentage of subjects with diabetes, hypertension and overall comorbidities and admitted to intensive care.

The investigators found ferritin level increased with older age, increasing proportion of hypertensive study participants and increasing proportion of mortality.

The investigators found compared to moderate cases, severe COVID-19 cases had lower hemoglobin level [WMD = -4.08 g/L, 95% CI = -5.12 to -3.05] and red blood cell count [WMD = -0.16 × 1012 /L, 95% CI = -0.31 to -0.014] and higher ferritin level [WMD = -473.25 ng/mL, 95% CI = 382.52 to 563.98] and red cell distribution width [WMD = 1.82%, 95% CI = 0.10 to 3.55].

The investigators found a significant difference in mean ferritin levels of 606.37 ng/mL [95% CI = 461.86 to 750.88] between survivors and non-survivors, but not in hemoglobin levels.

The investigators concluded severe COVID-19 patients have lower haemoglobin level and red blood cell count and higher ferritin level and red cell distribution. Future studies should explore the impact of iron metabolism and anemia in the pathophysiology, prognosis and treatment of COVID-19.

Original title:
Anemia and iron metabolism in COVID-19: a systematic review and meta-analysis by Taneri PE, Gómez-Ochoa SA, […], Muka T.

Link:
https://pubmed.ncbi.nlm.nih.gov/32816244/

Additional information of El Mondo:
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