Anemia and iron metabolism in COVID-19: a systematic review and meta-analysis.

Taneri, Petek Eylul; Gómez-Ochoa, Sergio Alejandro; Llanaj, Erand; Raguindin, Peter Francis; Rojas, Lyda Z; Roa-Díaz, Zayne Milena; Salvador, Dante Jr; Groothof, Dion; Minder, Beatrice; Kopp, Doris; Hautz, Wolf E.; Eisenga, Michele F; Franco, Oscar H.; Glisic, Marija; Muka, Taulant (2020). Anemia and iron metabolism in COVID-19: a systematic review and meta-analysis. European journal of epidemiology, 35(8), pp. 763-773. Springer 10.1007/s10654-020-00678-5

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Iron metabolism and anemia may play an important role in multiple organ dysfunction syndrome in Coronavirus disease 2019 (COVID-19). We conducted a systematic review and meta-analysis to evaluate 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) in patients diagnosed with COVID-19, and explored their prognostic value. Six bibliographic databases were searched up to August 3rd 2020. We included 189 unique studies, with data from 57,563 COVID-19 patients. Pooled mean hemoglobin and ferritin levels in COVID-19 patients across all ages were 129.7 g/L (95% Confidence Interval (CI), 128.51; 130.88) and 777.33 ng/mL (95% CI, 701.33; 852.77), respectively. Hemoglobin levels were lower with older age, higher percentage of subjects with diabetes, hypertension and overall comorbidities, and admitted to intensive care. Ferritin level increased with older age, increasing proportion of hypertensive study participants, and increasing proportion of mortality. Compared to moderate cases, severe COVID-19 cases had lower hemoglobin [weighted mean difference (WMD), - 4.08 g/L (95% CI - 5.12; - 3.05)] and red blood cell count [WMD, - 0.16 × 1012 /L (95% CI - 0.31; - 0.014)], and higher ferritin [WMD, - 473.25 ng/mL (95% CI 382.52; 563.98)] and red cell distribution width [WMD, 1.82% (95% CI 0.10; 3.55)]. A significant difference in mean ferritin levels of 606.37 ng/mL (95% CI 461.86; 750.88) was found between survivors and non-survivors, but not in hemoglobin levels. Future studies should explore the impact of iron metabolism and anemia in the pathophysiology, prognosis, and treatment of COVID-19.

Item Type:

Journal Article (Original Article)

Division/Institute:

13 Central Units > Administrative Director's Office > University Library of Bern
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > University Emergency Center
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

Graduate School:

Graduate School for Health Sciences (GHS)

UniBE Contributor:

Raguindin, Peter Francis; Roa Díaz, Zayne Milena; Salvador, Dante Jr.; Minder, Beatrice; Kopp, Doris; Hautz, Wolf; Franco Duran, Oscar Horacio; Glisic, Marija and Muka, Taulant

Subjects:

000 Computer science, knowledge & systems > 020 Library & information sciences
600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0393-2990

Publisher:

Springer

Language:

English

Submitter:

Andrea Flükiger-Flückiger

Date Deposited:

26 Aug 2020 12:31

Last Modified:

19 Feb 2021 18:54

Publisher DOI:

10.1007/s10654-020-00678-5

PubMed ID:

32816244

Additional Information:

Petek Eylul Taneri, Sergio Alejandro Gómez-Ochoa, Erand Llanaj, Peter Francis Raguindin
Marija Glisic, Taulant Muka have contributed equally to this work

Uncontrolled Keywords:

Anemia Covid-19 Ferritin Hemoglobin Iron Prognosis

BORIS DOI:

10.7892/boris.146092

URI:

https://boris.unibe.ch/id/eprint/146092

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