SARS–CoV-2-mediated hyperferritinemia and cardiac arrest: preliminary insights

VasanthiDharmalingam, Prakash; Karuppagounder, Vengadeshprabhu; Watanabe, Kenichi; Karmouty‐Quintana, Harry; Palaniyandi, Suresh S.; Guha, Ashrith; Thandavarayan, Rajarajan A.

Severe acute respiratory syndrome coronavirus 2 (SARS–CoV-2), a pandemic that began in China, was first noted in December 2019. SARS–CoV-2 infects through the angiotensin‐converting enzyme-2 (ACE-2) receptor and co-receptors. In the most severely affected patients, it can cause pneumonia and multiple organ failure leading to death. Reports describe high death rates resulting from cardiac dysfunction, a co-morbid condition in SARS–CoV-2 patients, while the primary cause and mechanisms remain unknown. Here, we attempt to review clinical reports of SARS–CoV-2 patients in order to provide insight into a possible mechanism that allows hyperferritinemia (the presence of excess iron-binding protein) to cause cardiac dysfunction in SARS–CoV-2 patients. Such insights are an important avenue towards understanding the mechanism of cardiac dysfunction in SARS–CoV-2 patients and developing remedies for the same.