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Free unbound iron possibly contributes to the hypercoagulation and inflammation found in severe COVID-19.
The nonapoptotic and immunogenic cell death “ferroptosis” may be a potential contributor to the pathogenesis of COVID-19.
The bioactive compound lactoferrin and other iron chelators may provide a high therapeutic value in the treatment of COVID-19.
The relatively lower risk for COVID-19 found in individuals with blood group O may be linked to a lower serum iron status in these individuals.
Iron overload is increasingly implicated as a contributor to the pathogenesis of COVID-19. Indeed, several of the manifestations of COVID-19, such as inflammation, hypercoagulation, hyperferritinemia, and immune dysfunction are also reminiscent of iron overload. Although iron is essential for all living cells, free unbound iron, resulting from iron dysregulation and overload, is very reactive and potentially toxic due to its role in the generation of reactive oxygen species (ROS). ROS react with and damage cellular lipids, nucleic acids, and proteins, with consequent activation of either acute or chronic inflammatory processes implicated in multiple clinical conditions. Moreover, iron-catalyzed lipid damage exerts a direct causative effect on the newly discovered nonapoptotic cell death known as ferroptosis. Unlike apoptosis, ferroptosis is immunogenic and not only leads to amplified cell death but also promotes a series of reactions associated with inflammation. Iron chelators are generally safe and are proven to protect patients in clinical conditions characterized by iron overload. There is also an abundance of evidence that iron chelators possess antiviral activities. Furthermore, the naturally occurring iron chelator lactoferrin (Lf) exerts immunomodulatory as well as anti-inflammatory effects and can bind to several receptors used by coronaviruses thereby blocking their entry into host cells. Iron chelators may consequently be of high therapeutic value during the present COVID-19 pandemic.Le texte complet de cet article est disponible en PDF.
Keywords : COVID-19, Hemoglobin damage, Iron overload, Free iron, Hypercoagulation, Hyperferritinemia, Inflammation, Blood groups, Lactoferrin, Iron chelators