Low transferrin levels predict heightened inflammation in patients with COVID-19: New insights

Catherine Claise, Jumana Saleh, Marwa Rezek, Sophie Vaulont, Carole Peyssonnaux, Marvin Edeas*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

15 Citations (Scopus)


Objectives: Mounting evidence links hyperinflammation in gravely ill patients to low serum iron levels and hyperferritinemia. However, little attention has been paid to other iron-associated markers such as transferrin. The aim of this study was to investigate the association of different iron parameters in severe COVID-19 and their relation to disease severity. Subjects and methods: This study involved 73 hospitalized patients with positive test results for SARS-CoV-2. Patients were classified into two groups according to symptom severity: mild and severe. Blood levels of anti–SARS-CoV-2 antibodies, interleukin 6 (IL-6), C-reactive protein (CRP), and iron-related biomarkers were measured. Results: The results revealed a significant increase in IL-6, CRP, and ferritin levels and decreased transferrin and iron levels in severe COVID-19. Transferrin negatively predicted variations in IgM and IgG levels (P < 0.001), as well as 34.4% and 36.6% increase in IL-6 and CRP levels, respectively (P < 0.005). Importantly, transferrin was the main negative predictor of ferritin levels, determining 22.7% of serum variations (P < 0.001). Conclusion: Reduced serum transferrin and iron levels, along with the increased CRP and high ferritin, were strongly associated with the heightened inflammatory and immune state in COVID-19. Transferrin can be used as a valuable predictor of increased severity and progression of the disease.

Original languageEnglish
Pages (from-to)74-79
Number of pages6
JournalInternational Journal of Infectious Diseases
Publication statusPublished - Mar 2022


  • Cytokine storm
  • Hyperferritinemia
  • IL-6
  • Serum iron
  • Transferrin
  • Transferrin saturation

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases


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