The mechanism of hypoferremia of inflammation. General inflammatory regulators are shown in grey, iron-regulatory pathway in green, iron flows in blue and erythropoiesis and erythrocytes in red. Source: Ganz, 2018.

Anemia in COVID-19 patients: an innate immune response? “Hepcidin-mediated iron sequestration protects against bacterial dissemination during pneumonia.”

Anemia is one of the hematologic findings in patients with COVID-19 related pneumonia. There are speculations that erythrocytes may be infected by SARS-CoV-2 which would explain or contribute to anemia. However, we should not forget that there is a potent innate immune response, hepcidin-mediated iron sequestration, that also results in anemia, “anemia of inflammation” (1).

FIG. 1. Schematic representation of the cycle of iron delivery to cells by transferrin, showing the uptake of diferric transferrin by cell receptors, internalization, release of iron at the lower intracellular pH, and recycling and release of apotransferrin.

Transferrin and lactoferrin.

This post is a work in progress. Last review and update: January 31, 2020. A short summary. This article contains … More