Revised clinical standards for assessing sepsis: Serum iron level as an emerging biomarker

Iron is a vital trace element for basic human and bacteria processes. Iron metabolism is altered in sepsis, decreasing iron export and increasing iron transport and cell uptake. As a defense against circulating infections, intracellular iron sequestration restricts their availability. Although iron retention has been shown to have protective effects, an upsurge in labile iron may result in oxidative injury and cell death (e.g., pyroptosis and ferroptosis) as the condition worsens. A recent meta-analysis has revealed a correlation between high serum iron levels and intensive care unit mortality. However, low serum iron levels have traditionally been associated with increased mortality rates. This letter highlights the need for further research to re-evaluate this contradictory finding and comprehend sepsis's pathophysiological mechanisms. We emphasize the need for additional knowledge to make serum iron levels a valuable prognostic and diagnostic marker.