akusherstvoObstetrics, Gynecology and ReproductionАкушерство, Гинекология и Репродукция2313-73472500-3194IRBIS LLC10.17749/2313-7347/ob.gyn.rep.2020.179akusherstvo-831Research ArticleREVIEW ARTICLESНАУЧНЫЕ ОБЗОРЫCOVID-19 and iron deficiency anemia: relationships of pathogenesis and therapyCOVID-19 и железодефицитная анемия: взаимосвязи патогенеза и терапииhttps://orcid.org/0000-0002-7663-710XГромоваО. А.GromovaO. A.

Громова Ольга Алексеевна - доктор медицинских наук, профессор, ведущий научный сотрудник, научный руководитель Института фармакоинформатики ФИЦ ИУ РАН; ведущий научный сотрудник Центра хранения и анализа больших данных МГУ имени М.В. Ломоносова.119333 Москва, ул. Вавилова, д. 42; 119234 Москва, Ленинские горы, д. 1.Scopus Author ID: 7003589812Researcher ID: J-4946-2017Author ID: 94901. WOS ID: J-4946-2017

Olga A. Gromova - MD, Dr Sci Med, Professor, Leading Researcher, Scientific Director, Institute of Pharmacoinformatics, Federal Research Center «Informatics and Management», Russian Academy of Sciences; Leading Researcher, Big Data Storage and Analysis Center, Lomonosov Moscow State University.42 Vavilova Str., Moscow 119333; 1 Leninskie Gory, Moscow 119234.Scopus Author ID: 7003589812Researcher ID: J-4946-2017Author ID: 94901. WOS ID: J-4946-2017

unesco.gromova@gmail.comhttps://orcid.org/0000-0002-2659-7998ТоршинИ. Ю.TorshinI. Yu.

Торшин Иван Юрьевич - кандидат физико-математических наук, кандидат химических наук, старший научный сотрудник Института фармакоинформатики ФИЦ ИУ РАН; старший научный сотрудник Центра хранения и анализа больших данных МГУ имени М.В. Ломоносова.119333 Москва, ул. Вавилова, д. 42; 119234 Москва, Ленинские горы, д. 1.Scopus Author ID: 7003300274Researcher ID: C-7683-2018Author ID: 54104. WOS ID: C-7683-2018

Ivan Yu. Torshin - PhD (Chemistry), PhD in Applied Mathematics, Senior Researcher, Institute of Pharmacoinformatics, Federal Research Center «Informatics and Management», Russian Academy of Sciences; Senior Researcher, Big Data Storage and Analysis Center, Lomonosov Moscow State University.42 Vavilova Str., Moscow 119333; 1 Leninskie Gory, Moscow 119234.Scopus Author ID: 7003300274Researcher ID: C-7683-2018Author ID: 54104. WOS ID: C-7683-2018

https://orcid.org/0000-0002-8558-1216ШаповаловаЮ. О.ShapovalovaYu. O.

Шаповалова Юлия Олеговна - врач акушер-гинеколог.143081 Московская область, Одинцовский район, Лапино, 1-е Успенское шоссе, д. 111.

Yuliya O. Shapovalova - MD, Obstetrician-Gynecologist, Lapino Clinic Hospital, MD Medical Group.42 Vavilova Str., Moscow 119333; 1 Leninskie Gory, Moscow 119234.

https://orcid.org/0000-0003-0175-1968КурцерМ. А.KurtserM. A.

Курцер Марк Аркадьевич - доктор медицинских наук, профессор, академик РАН, зав. кафедрой акушерства и гинекологии педиатрического факультета.117997 Москва, ул. Островитянова, д. 1.

Mark A. Kurtser - MD, Dr Sci Med, Professor, Academician of RAS, Head of the Department of Obstetrics and Gynecology, Faculty of Pediatrics, Pirogov Russian National Research Medical University; General Director of MD Medical Group.1 Ostrovityanova Str., Moscow 117997.

https://orcid.org/0000-0002-5070-5450ЧучалинА. Г.ChuchalinA. G.

Чучалин Александр Григорьевич - доктор медицинских наук, профессор, академик РАН, зав. кафедрой госпитальной терапии педиатрического факультета.117997 Москва, ул. Островитянова, д. 1.

Alexander G. Chuchalin - MD, Dr Sci Med, Professor, Academician of RAS, Head of the Department of Hospital Therapy, Faculty of Pediatrics, Pirogov Russian National Research Medical University.1 Ostrovityanova Str., Moscow 117997.

Институт фармакоинформатики ФГБУ «Федеральный исследовательский центр "Информатика и управление" Российской академии наук»; Московский государственный университет имени М.В. ЛомоносоваРоссияInstitute of Pharmacoinformatics, Federal Research Center «Informatics and Management», Russian Academy of Sciences; Big Data Storage and Analysis Center, Lomonosov Moscow State UniversityRussian FederationКлинический Госпиталь Лапино, ГК «Мать и Дитя»РоссияLapino Clinic Hospital, MD Medical GroupRussian FederationРоссийский национальный исследовательский медицинский университет имени Н.И. Пирогова Министерства здравоохранения Российской ФедерацииРоссияPirogov Russian National Research Medical University, Health Ministry of Russian FederationRussian Federation202023112020145644655Copyright © Gromova O.A., Torshin I.Y., Shapovalova Y.O., Kurtser M.A., Chuchalin A.G., 20202020Громова О.А., Торшин И.Ю., Шаповалова Ю.О., Курцер М.А., Чучалин А.Г.Gromova O.A., Torshin I.Y., Shapovalova Y.O., Kurtser M.A., Chuchalin A.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gynecology.su/jour/article/view/831

During pregnancy, a woman becomes more susceptible to respiratory and viral diseases, including novel coronavirus infection (COVID-19). Pregnancy exacerbates the acute inflammation typical to COVID-19, elevating a risk of developing cytokine storm, characterized by an avalanche-like spike of inflammation marker concentrations (C-reactive protein, interleukin-1 в, interleukin-6, interferon-Y, ferritin, erythrocyte sedimentation rate etc.). Cytokine storm increases a risk of pregnancy loss and contribute to formation of multiple organ dysfunction syndrome in pregnant women and fetus. In particular, erythrocyte degradation due to acute inflammation leads to hypoxia and uncontrolled inter-tissue iron redistribution. As a result, conditions are created simultaneously for developing pulmonary hemosiderosis and hemosiderosis of other tissues in pregnant woman and fetus, as well as for augmenting iron loss from the body, which exacerbates iron deficiency anemia (IDA). It is important to emphasize that a surge of ferritin level distinctive for severe COVID-19, does not indicate iron overload. Therefore, recommendations to cancel IDA correction and even to use iron chelators in COVID-19 may increase hypoxia and harm the health of pregnant women.

При беременности женщина становится более подверженной респираторно-вирусным заболеваниям, в том числе корона-вирусной инфекции COVID-19. Беременность обостряет характерное для COVID-19 острое воспаление, повышая риск цитокинового шторма, характеризующегося лавинообразным нарастанием концентраций маркёров воспаления (С-реактивный белок, интерлейкин-1 в, интерлейкин-6, интерферон-у, ферритин, скорость оседания эритроцитов и др.). Цитокиновый шторм повышает риск потери беременности и способствует формированию полиорганной патологии у беременной и плода. В частности, деструкция эритроцитов вследствие острого воспаления приводит к гипоксии и к бесконтрольному перераспределению железа между тканями. В результате создаются условия одновременно как для формирования гемосидероза лёгких и других тканей беременной и плода, так и для усиления потерь железа организмом, которые усугубляют железодефицитную анемию (ЖДА) у беременной. Важно подчеркнуть, что резкое повышение уровня ферритина, характерное для более тяжёлого течения COVID-19, само по себе не свидетельствует о перегрузке железом. Поэтому рекомендации по отмене коррекции ЖДА и даже по использованию хелаторов железа при COVID-19 могут увеличивать гипоксию и наносить вред здоровью беременных.

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The authors declare that there are no conflicts of interest present.