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在住院COVID-19患者中评估铁代谢
Thibaud Lefebvre1, Anne Boutten2, Célia Raulet-Bussian2
1Centre Français des Porphyries, Hôpital Louis Mourier, DMU BIOGEM, APHP, Colombes, France; Université Paris Cité, Centre de Recherche sur l'Inflammation, INSERM, UMR1149, Laboratoire d'Excellence GR-Ex, Paris, France.
概括
COVID-19显著改变铁的新陈代谢,观察到糖化酸的降低和低水平的铁. 高水平的费里和糖化费里与死亡率有关,这表明在严重病例中存在复杂的铁失调.
科学领域:
- 生物化学 生化学
- 免疫学 免疫学 免疫学
- 关键护理医学 关键护理医学
背景情况:
- 铁代谢失调与2019年冠状病毒病 (COVID-19) 的器官衰竭有关.
- 了解COVID-19患者的铁质概况对于管理疾病进展和器官损伤至关重要.
研究的目的:
- 为了研究住院COVID-19患者的综合铁代谢.
- 评估托西利祖马布对铁参数和患者治疗结果的影响.
主要方法:
- 一项观察性多中心队列研究,涉及104名住院COVID-19患者 (66名ICU,38名医疗病房).
- 测量了interleukin-6 (IL-6),ferritin,糖化ferritin (GF),转移素,铁和肝素的血清水平.
- 主要终点是死亡率.
主要成果:
- 患者表现出中位数降低的糖基化费里丁 (35%),低的铁度 (7.5μmol/L) 和低的转林和 (21%).
- 肝素度升高 (58.7 ng/mL),一些患者显示IL-6和肝素之间的分离.
- 增加的IL-6,费里丁和GF独立地与更高的死亡风险有关,tocilizumab的效应被放大了.
结论:
- COVID-19深刻改变了铁代谢,偏离了典型的炎症模式.
- 在一小部分患者中观察到未结合的IL-6/hepcidin水平.
- 由于这些独特的代谢变化,在COVID-19中额外的铁化疗法的疗效需要仔细考虑.
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