4 Citations (Scopus)


Ferritin, the central iron storage protein, has attracted attention as a biomarker of severe COVID-19. Few studies have investigated regulators of iron metabolism in the context of COVID-19. The aim was to evaluate biomarkers for iron metabolism in the acute phase response to community-acquired pneumonia (CAP) caused by SARS-CoV-2 compared with CAP caused by bacteria or influenza virus in hospitalized patients. A cross-sectional study of 164 patients from the Surviving Pneumonia Cohort recruited between January 8, 2019 and May 26, 2020. Blood samples were collected at admission and analyzed for levels of C-reactive protein (CRP), ferritin, soluble transferrin receptor, erythroferrone, and hepcidin. Median (IQR) hepcidin was higher in SARS-CoV-2 with 143.8 (100.7-180.7) ng/mL compared with bacterial and influenza infection with 78.8 (40.1-125.4) and 53.5 (25.2-125.8) ng/mL, respectively. The median ferritin level was more than 2-fold higher in patients with SARS-CoV-2 compared with the other etiologies (p < 0.001). Patients with SARS-CoV-2 had lower levels of erythroferrone and CRP compared with those infected with bacteria. Higher levels of hepcidin and lower levels of erythroferrone despite lower CRP levels among patients with SARS-CoV-2 compared with those infected with bacteria indicate alterations in iron metabolism in patients with SARS-CoV-2 infection.

Original languageEnglish
JournalAPMIS - Journal of Pathology, Microbiology and Immunology
Issue number9
Pages (from-to)590-596
Number of pages7
Publication statusPublished - Sept 2022


  • Biomarkers/blood
  • C-Reactive Protein/metabolism
  • COVID-19/complications
  • Community-Acquired Infections/blood
  • Cross-Sectional Studies
  • Ferritins
  • Hepcidins/metabolism
  • Humans
  • Influenza, Human/complications
  • Iron/metabolism
  • Pneumonia, Bacterial/blood
  • Pneumonia, Viral/blood
  • SARS-CoV-2
  • ferritin
  • hepcidin
  • community-acquired pneumonia
  • COVID-19
  • iron metabolism
  • erythroferrone


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