Serum iron level as a potential predictor of COVID-19 severity and mortality: a retrospective study

Zhao, Kang; Huang, Jucun; Dai, Dan; Feng, Yuwei; Liu, Liming; Nie, Shuke

BACKGROUND: Various types of pulmonary diseases are associated with iron deficiency. However, information on iron status in COVID-19 is scarce. METHODS: This study included 50 hospitalized patients with confirmed COVID-19. The role of serum iron in predicting severity and mortality of COVID-19 was evaluated. RESULTS: The most common symptoms of COVID-19 patients in this study were cough (82%), fever (64%), and chest distress (42%). Of the 50 patients, 45 (90%) patients had abnormally low serum iron levels (<7.8 μmol/L). The severity of COVID-19 was negatively correlated with serum iron levels before and after treatment and was positively correlated with C-reactive protein (CRP), serum amyloid A (SAA), D-dimer, lactate dehydrogenase (LDH), urea nitrogen, and myoglobin levels. Decreased serum iron level could predict the transition of COVID-19 from mild to severe and critical illness. 7 (53.8%) patients with lower serum iron level after treatment in the critical group had died. There was a significant difference in post-treatment serum iron levels between COVID-19 survivors and non-survivors . CONCLUSIONS: Serum iron deficiency was detected in the patients with COVID-19. The severity and mortality of the disease was closely correlated with serum iron levels. Low serum iron concentration was an independent risk factor for death in COVID-19 patients.