Hepcidin levels predict COVID-19 severity and mortality in a cohort of hospitalized italian patients

Published: 10 February 2022| Version 1 | DOI: 10.17632/6h37h7357n.1
, Laura Silvestri, Patrizia Rovere-Querini, Nicola Ivan Lorè, Alessia Pagani, Rebecca De Lorenzo,
, Daniela Maria Cirillo, Angelo Manfredi


Several risk factors for SARS-COV2 infection are well established, including advanced age, male gender, strong inflammatory response, neutropenia and lymphopenia, and more recently hypoferremia. Hepcidin, the liver peptide hormone whose role is to regulate iron concentration in the blood stream, is at the crossroad between iron metabolism and inflammation, being positively regulated by iron itself and proinflammatory cytokines. However, its role as potential biomarker of COVID-19 severity has only partially been explored. In this paper, we analyzed plasma hepcidin levels in a well-characterized cohort of 111 Italian COVID-19 patients admitted at San Raffaele University Hospital, in Milan. In this cohort, all patients are hypoferremic and hepcidin levels do not correlate with iron, instead hepcidin expression is mainly driven by inflammation and correlates with markers of lung function. Although plasma iron levels remain equally low in all groups examined, both in hypoxemic and in non-surviving patients hepcidin levels are higher than in the corresponding control groups likely due to the strong inflammation. More interestingly, in critical patients in intensive care unit hepcidin is an independent predictor of mortality, at difference with parameters of inflammation. Overall our data add hepcidin as a marker of morbidity and outcome, especially in severely compromised patients. doi: 10.1002/ajh.26027



Ospedale San Raffaele


Inflammation, Iron Metabolism, COVID-19