Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Apr;50(2):547-552.
doi: 10.1007/s15010-021-01722-6. Epub 2021 Oct 20.

Cardiac iron overload promotes cardiac injury in patients with severe COVID-19

Maria J Baier  1 , Stefan Wagner  1 , Julian Hupf  2 , Katja Evert  3 , Matthias Evert  3 , Samuel Sossalla  1 , Carsten Jungbauer  1 , Lars S Maier  1 , Stefan Neef  1 , Julian Mustroph  4
Affiliations

Cardiac iron overload promotes cardiac injury in patients with severe COVID-19

Maria J Baier et al. Infection. 2022 Apr.
No abstract available

PubMed Disclaimer

Conflict of interest statement

No conflict of interest declared.

Figures

Fig. 1
Fig. 1
Iron metabolism in left ventricular (LV) myocardium of deceased COVID‐19 patients. A In the LV myocardium of deceased COVID‐19 patients, iron concentration is significantly increased compared to the non-failing group (NF; p = 0.004, t test, n = 6–7). B In LV myocardium of deceased COVID‐19 patients, protein expression of ferritin heavy chain (FTH) to ferritin light chain (FTL) is significantly decreased compared to NF group (p = 0.005, Mann–Whitney test, n = 6–7). C In LV myocardium of deceased COVID‐19 patients, ratio of ferritin heavy chain (FTH) to ferritin light chain (FTL) mRNA is significantly decreased compared to NF (p = 0.007) and SEPSIS group (p = 0.03, Kruskal–Wallis test, n = 6–7). D In LV myocardium of deceased COVID-19 patients, glutathione peroxidase 4 (GPX4) is decreased compared to NF (p = 0.03) and SEPSIS group (p = 0.01, Brown-Forsythe/Welch ANOVA test, n = 6–7). E In LV myocardium of deceased COVID‐19 patients, heme oxygenase-1 (HMOX-1) is significantly increased compared to NF (p = 0.01) and SEPSIS group (p = 0.008, one-way ANOVA test, n = 6–7). F In LV myocardium sections of deceased COVID-19 patients, 4-HNE staining, a marker for oxidative stress, is significantly enhanced compared to SEPSIS group (p = 0.001, t test, n = 8 each) (4-HNE: green, WGA: red, DAPI: blue). G 4-HNE staining and troponin levels are significantly correlated in COVID-19 patients (p = 0.03, R2 = 0.57, n = 8, linear regression)
Fig. 2
Fig. 2
Graphical overview. In myocardium, SARS-CoV-2 infection increases iron concentration, decreases intracellular iron storage capacity and inhibits detoxifying enzymes, leading to excessive increase in the labile iron pool (LIP). As a result, reactive oxygen species (ROS) formation and lipid peroxidation occur, leading to ferroptosis. (SARS-CoV-2 figure by CDC/Alissa Eckert, MS; Dan Higgins, MAMS)
See this image and copyright information in PMC

References

    1. Sattar Y, Ullah W, Rauf H, Virk HUH, Yadav S, Chowdhury M, Connerney M, Mamtani S, Pahuja M, Patel RD, Mir T, Almas T, Moussa Pacha H, Chadi AM. COVID-19 cardiovascular epidemiology, cellular pathogenesis, clinical manifestations and management. Int J Cardiol Heart Vasc. 2020;29:100589. doi: 10.1016/j.ijcha.2020.100589. - DOI - PMC - PubMed
    1. Sonnweber T, Boehm A, Sahanic S, Pizzini A, Aichner M, Sonnweber B, Kurz K, Koppelstätter S, Haschka D, Petzer V, Hilbe R, Theurl M, Lehner D, Nairz M, Puchner B, Luger A, Schwabl C, Bellmann-Weiler R, Wöll E, Widmann G, Tancevski I, Löffler-Ragg J, Weiss G. Persisting alterations of iron homeostasis in COVID-19 are associated with non-resolving lung pathologies and poor patients’ performance: a prospective observational cohort study. Respir Res. 2020;21:276. doi: 10.1186/s12931-020-01546-2. - DOI - PMC - PubMed
    1. Bellmann-Weiler R, Lanser L, Barket R, Rangger L, Schapfl A, Schaber M, Fritsche G, Wöll E, Weiss G. Prevalence and predictive value of anemia and dysregulated iron homeostasis in patients with COVID-19 infection. J Clin Med. 2020;9:2429. doi: 10.3390/jcm9082429. - DOI - PMC - PubMed
    1. Hippchen T, Altamura S, Muckenthaler MU, Merle U. Hypoferremia is associated with increased hospitalization and oxygen demand in COVID-19 patients. Hemasphere. 2020;4:e492. doi: 10.1097/HS9.0000000000000492. - DOI - PMC - PubMed
    1. Chiang SK, Chen SE, Chang LC. A dual role of heme oxygenase-1 in cancer cells. Int J Mol Sci. 2018;20:39. doi: 10.3390/ijms20010039. - DOI - PMC - PubMed

Publication types