long covid

intravenous iron

Kidney International

The screening for coronavirus disease 2019 (COVID-19) is challenging: many patients are asymptomatic, viral RNA detection in a nasopharyngeal swab is falsely negative in 30%, and a pulmonary computed tomography scan is useless in patients with no pulmonary involvement.1Shi H. Han X. Jiang N. et al.Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study.Lancet Infect Dis. 2020; 20: 425-434Abstract Full Text Full Text PDF PubMed Scopus (2487) Google Scholar,2Li Y. Xia L. Coronavirus disease 2019 (COVID-19): role of chest CT in diagnosis and management.AJR Am J Roentgenol. 2020; 214: 1280-1286Crossref PubMed Scopus (818) Google Scholar In our hemodialysis center, following the Kidney Disease Improving Global Outcomes recommendations, ferritin levels are measured each month to detect iron deficiency.3Chapter 1: diagnosis and evaluation of anemia in CKD.Kidney Int Suppl. 2012; 2: 288-291Abstract Full Text Full Text PDF Scopus (35) Google Scholar In April 2020, there were 22 COVID-19 cases that had occurred within the 270 patients undergoing hemodialysis at our hemodialysis center. We noticed that ferritin levels were very high in these patients (Figure 1). When monthly ferritin levels were measured in April, 1 of our female patients had an unusually high ferritin level of 3806 ng/ml compared with 531 ng/ml previously. A clinical examination showed no clinical symptoms of COVID-19, but she was tested by nasopharyngeal swab and was shown to be positive. We compared ferritin levels in patients undergoing hemodialysis who tested positive and negative for COVID-19 at our dialysis center in the month preceding viral infection and during infection and found a critical difference (Figure 1). In the patients who tested positive for COVID-19, the mean (±SD) ferritin levels in March (before viral infection) and at diagnosis were 584 ± 318 and 1446 ± 1261 ng/ml, respectively, which was a mean increase of 275%. Interestingly, ferritin levels were increased at diagnosis in the 5 asymptoma...

Could ferritin help the screening for COVID-19 in hemodialysis patients?