Iron metabolism and lymphocyte characterisation during Covid-19 infection in ICU patients: an observational cohort study

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Iron metabolism and lymphocyte characterisation during Covid-19 infection in ICU patients : an observational cohort study. / Bolondi, Giuliano; Russo, Emanuele; Gamberini, Emiliano; Circelli, Alessandro; Meca, Manlio Cosimo Claudio; Brogi, Etrusca; Viola, Lorenzo; Bissoni, Luca; Poletti, Venerino; Agnoletti, Vanni.

I: World Journal of Emergency Surgery, Bind 15, Nr. 1, 41, 2020.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

Harvard

Bolondi, G, Russo, E, Gamberini, E, Circelli, A, Meca, MCC, Brogi, E, Viola, L, Bissoni, L, Poletti, V & Agnoletti, V 2020, 'Iron metabolism and lymphocyte characterisation during Covid-19 infection in ICU patients: an observational cohort study', World Journal of Emergency Surgery, bind 15, nr. 1, 41. https://doi.org/10.1186/s13017-020-00323-2

APA

Bolondi, G., Russo, E., Gamberini, E., Circelli, A., Meca, M. C. C., Brogi, E., Viola, L., Bissoni, L., Poletti, V., & Agnoletti, V. (2020). Iron metabolism and lymphocyte characterisation during Covid-19 infection in ICU patients: an observational cohort study. World Journal of Emergency Surgery, 15(1), [41]. https://doi.org/10.1186/s13017-020-00323-2

CBE

Bolondi G, Russo E, Gamberini E, Circelli A, Meca MCC, Brogi E, Viola L, Bissoni L, Poletti V, Agnoletti V. 2020. Iron metabolism and lymphocyte characterisation during Covid-19 infection in ICU patients: an observational cohort study. World Journal of Emergency Surgery. 15(1):Article 41. https://doi.org/10.1186/s13017-020-00323-2

MLA

Vancouver

Bolondi G, Russo E, Gamberini E, Circelli A, Meca MCC, Brogi E o.a. Iron metabolism and lymphocyte characterisation during Covid-19 infection in ICU patients: an observational cohort study. World Journal of Emergency Surgery. 2020;15(1). 41. https://doi.org/10.1186/s13017-020-00323-2

Author

Bolondi, Giuliano ; Russo, Emanuele ; Gamberini, Emiliano ; Circelli, Alessandro ; Meca, Manlio Cosimo Claudio ; Brogi, Etrusca ; Viola, Lorenzo ; Bissoni, Luca ; Poletti, Venerino ; Agnoletti, Vanni. / Iron metabolism and lymphocyte characterisation during Covid-19 infection in ICU patients : an observational cohort study. I: World Journal of Emergency Surgery. 2020 ; Bind 15, Nr. 1.

Bibtex

@article{caf1204e9f0842bca8392abde9e791b4,
title = "Iron metabolism and lymphocyte characterisation during Covid-19 infection in ICU patients: an observational cohort study",
abstract = "BACKGROUND: Iron metabolism and immune response to SARS-CoV-2 have not been described yet in intensive care patients, although they are likely involved in Covid-19 pathogenesis. METHODS: We performed an observational study during the peak of pandemic in our intensive care unit, dosing D-dimer, C-reactive protein, troponin T, lactate dehydrogenase, ferritin, serum iron, transferrin, transferrin saturation, transferrin soluble receptor, lymphocyte count and NK, CD3, CD4, CD8 and B subgroups of 31 patients during the first 2 weeks of their ICU stay. Correlation with mortality and severity at the time of admission was tested with the Spearman coefficient and Mann-Whitney test. Trends over time were tested with the Kruskal-Wallis analysis. RESULTS: Lymphopenia is severe and constant, with a nadir on day 2 of ICU stay (median 0.555 109/L; interquartile range (IQR) 0.450 109/L); all lymphocytic subgroups are dramatically reduced in critically ill patients, while CD4/CD8 ratio remains normal. Neither ferritin nor lymphocyte count follows significant trends in ICU patients. Transferrin saturation is extremely reduced at ICU admission (median 9%; IQR 7%), then significantly increases at days 3 to 6 (median 33%, IQR 26.5%, p value 0.026). The same trend is observed with serum iron levels (median 25.5 μg/L, IQR 69 μg/L at admission; median 73 μg/L, IQR 56 μg/L on days 3 to 6) without reaching statistical significance. Hyperferritinemia is constant during intensive care stay: however, its dosage might be helpful in individuating patients developing haemophagocytic lymphohistiocytosis. D-dimer is elevated and progressively increases from admission (median 1319 μg/L; IQR 1285 μg/L) to days 3 to 6 (median 6820 μg/L; IQR 6619 μg/L), despite not reaching significant results. We describe trends of all the abovementioned parameters during ICU stay. CONCLUSIONS: The description of iron metabolism and lymphocyte count in Covid-19 patients admitted to the intensive care unit provided with this paper might allow a wider understanding of SARS-CoV-2 pathophysiology.",
keywords = "Coagulation, Coronavirus, COVID-19, Critical care, Ferritins, Immunity, Iron, Lymphocytes, Lymphopenia, MeSH repository (3-10), SARS-CoV-2",
author = "Giuliano Bolondi and Emanuele Russo and Emiliano Gamberini and Alessandro Circelli and Meca, {Manlio Cosimo Claudio} and Etrusca Brogi and Lorenzo Viola and Luca Bissoni and Venerino Poletti and Vanni Agnoletti",
year = "2020",
doi = "10.1186/s13017-020-00323-2",
language = "English",
volume = "15",
journal = "World Journal of Emergency Surgery",
issn = "1749-7922",
publisher = "BioMed Central",
number = "1",

}

RIS

TY - JOUR

T1 - Iron metabolism and lymphocyte characterisation during Covid-19 infection in ICU patients

T2 - an observational cohort study

AU - Bolondi, Giuliano

AU - Russo, Emanuele

AU - Gamberini, Emiliano

AU - Circelli, Alessandro

AU - Meca, Manlio Cosimo Claudio

AU - Brogi, Etrusca

AU - Viola, Lorenzo

AU - Bissoni, Luca

AU - Poletti, Venerino

AU - Agnoletti, Vanni

PY - 2020

Y1 - 2020

N2 - BACKGROUND: Iron metabolism and immune response to SARS-CoV-2 have not been described yet in intensive care patients, although they are likely involved in Covid-19 pathogenesis. METHODS: We performed an observational study during the peak of pandemic in our intensive care unit, dosing D-dimer, C-reactive protein, troponin T, lactate dehydrogenase, ferritin, serum iron, transferrin, transferrin saturation, transferrin soluble receptor, lymphocyte count and NK, CD3, CD4, CD8 and B subgroups of 31 patients during the first 2 weeks of their ICU stay. Correlation with mortality and severity at the time of admission was tested with the Spearman coefficient and Mann-Whitney test. Trends over time were tested with the Kruskal-Wallis analysis. RESULTS: Lymphopenia is severe and constant, with a nadir on day 2 of ICU stay (median 0.555 109/L; interquartile range (IQR) 0.450 109/L); all lymphocytic subgroups are dramatically reduced in critically ill patients, while CD4/CD8 ratio remains normal. Neither ferritin nor lymphocyte count follows significant trends in ICU patients. Transferrin saturation is extremely reduced at ICU admission (median 9%; IQR 7%), then significantly increases at days 3 to 6 (median 33%, IQR 26.5%, p value 0.026). The same trend is observed with serum iron levels (median 25.5 μg/L, IQR 69 μg/L at admission; median 73 μg/L, IQR 56 μg/L on days 3 to 6) without reaching statistical significance. Hyperferritinemia is constant during intensive care stay: however, its dosage might be helpful in individuating patients developing haemophagocytic lymphohistiocytosis. D-dimer is elevated and progressively increases from admission (median 1319 μg/L; IQR 1285 μg/L) to days 3 to 6 (median 6820 μg/L; IQR 6619 μg/L), despite not reaching significant results. We describe trends of all the abovementioned parameters during ICU stay. CONCLUSIONS: The description of iron metabolism and lymphocyte count in Covid-19 patients admitted to the intensive care unit provided with this paper might allow a wider understanding of SARS-CoV-2 pathophysiology.

AB - BACKGROUND: Iron metabolism and immune response to SARS-CoV-2 have not been described yet in intensive care patients, although they are likely involved in Covid-19 pathogenesis. METHODS: We performed an observational study during the peak of pandemic in our intensive care unit, dosing D-dimer, C-reactive protein, troponin T, lactate dehydrogenase, ferritin, serum iron, transferrin, transferrin saturation, transferrin soluble receptor, lymphocyte count and NK, CD3, CD4, CD8 and B subgroups of 31 patients during the first 2 weeks of their ICU stay. Correlation with mortality and severity at the time of admission was tested with the Spearman coefficient and Mann-Whitney test. Trends over time were tested with the Kruskal-Wallis analysis. RESULTS: Lymphopenia is severe and constant, with a nadir on day 2 of ICU stay (median 0.555 109/L; interquartile range (IQR) 0.450 109/L); all lymphocytic subgroups are dramatically reduced in critically ill patients, while CD4/CD8 ratio remains normal. Neither ferritin nor lymphocyte count follows significant trends in ICU patients. Transferrin saturation is extremely reduced at ICU admission (median 9%; IQR 7%), then significantly increases at days 3 to 6 (median 33%, IQR 26.5%, p value 0.026). The same trend is observed with serum iron levels (median 25.5 μg/L, IQR 69 μg/L at admission; median 73 μg/L, IQR 56 μg/L on days 3 to 6) without reaching statistical significance. Hyperferritinemia is constant during intensive care stay: however, its dosage might be helpful in individuating patients developing haemophagocytic lymphohistiocytosis. D-dimer is elevated and progressively increases from admission (median 1319 μg/L; IQR 1285 μg/L) to days 3 to 6 (median 6820 μg/L; IQR 6619 μg/L), despite not reaching significant results. We describe trends of all the abovementioned parameters during ICU stay. CONCLUSIONS: The description of iron metabolism and lymphocyte count in Covid-19 patients admitted to the intensive care unit provided with this paper might allow a wider understanding of SARS-CoV-2 pathophysiology.

KW - Coagulation

KW - Coronavirus

KW - COVID-19

KW - Critical care

KW - Ferritins

KW - Immunity

KW - Iron

KW - Lymphocytes

KW - Lymphopenia

KW - MeSH repository (3-10)

KW - SARS-CoV-2

UR - http://www.scopus.com/inward/record.url?scp=85087402953&partnerID=8YFLogxK

U2 - 10.1186/s13017-020-00323-2

DO - 10.1186/s13017-020-00323-2

M3 - Journal article

C2 - 32605582

AN - SCOPUS:85087402953

VL - 15

JO - World Journal of Emergency Surgery

JF - World Journal of Emergency Surgery

SN - 1749-7922

IS - 1

M1 - 41

ER -