Post Covid telogen effluvium: the diagnostic value of serum ferritin biomarker and the preventive value of dietary supplements. a case control study.

Nermeen Ibrahim Bedair, Alaa Safwat Abdelaziz, Fatemaalzahraa Saad Abdelrazik, Mohamed El-Kassas, Mohamed Hussein AbouHadeed

Other Archives of dermatological research 2024 5 citations

PubMed DOI CC-BY PDF

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Study Design

Type d'étude: Case-control
Taille de l'échantillon: 100

Intervention: Post Covid telogen effluvium: the diagnostic value of serum ferritin biomarker and the preventive value of dietary supplements. a case control study. None
Comparateur: Placebo
Direction de l'effet: Mixed
Risque de biais: Moderate

Abstract

Telogen effluvium is characterized by excessive hair shedding usually following a stressful event. Ferritin has been used in clinical practice as a biomarker of nonanemic iron deficiency in cases of telogen effluvium. During the years of the COVID19 pandemic, telogen effluvium was reported as a part of post covid manifestations. As ferritin was also a biomarker for inflammation in cases with covid infection, this study was designed to evaluate the value of ferritin in cases with postcovid telogen effluvium one hundred patients recovering from covid 19 for 4-12 weeks were included in the study, detailed drug and laboratory history was obtained and serum ferritin level was measured. the mean serum level of ferritin among telogen effluvium patients was significantly lower than controls (68.52 ± 126 and 137 ± 137.597 ug/L respectively). Patients with telogen effluvium used significantly more azithromycin and ivermectin and significantly less vitamin C, D, lactoferrin and zinc than the controls Although serum ferritin is lower among telogen effluvium patients, it was still higher than the cutoff value for diagnosing nonanemic iron deficiency, we suggest that it will not be a good biomarkers in these cases. Our secondary outcomes showed that dietary supplements used during active infection such as vitamin C, D, lactoferrin and zinc might have a preventive value on postcovid hair loss, while azithromycin and ivermectin could have a negative long term effect on telogen effluvium.

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Fig. 1

Tables

Table 1

		Group		X²	P-value
		Hair fall N = 50	Control N = 50	X²	P-value
Gender	Female	48 (96%)	31 (62%)	17.42	< 0.0001
Gender	Male	2 (4%)	19 (38%)	17.42	< 0.0001
Age	Mean ± SD	27.64 ± 6.04	33.84 ± 8.68	4.14	< 0.0001
	Median	27	32
	Min- Max	18–45	18–55
Duration since diagnosis (Weeks)	Mean ± SD	13.10 ± 5.76	12.92 ± 6.15	0.151	0.880
	Median	12	13
	Range	4–28	4–24

Table 2

		Group		P-value
		Hair fall N = 50	Control N = 50	P-value
Azithromycin	No	13 (26%)	35 (70%)	< 0.0001
Azithromycin	Yes	37 (74%)	15 (30%)	< 0.0001
Ivermectin	No	24 (48%)	38 (76%)	0.004
Ivermectin	Yes	26 (52%)	12 (24%)	0.004
Paracetamol		50 (100%)	50 (100%)	-
Vit-C	No	36 (72%)	15 (30%)	< 0.0001
Vit-C	Yes	14 (28.0%)	35 (70%)	< 0.0001
Vit-D	No	48 (96%)	36 (72%)	0.001
Vit-D	Yes	2 (4%)	14 (28%)	0.001
Zinc	No	33 (66%)	8 (16%)	< 0.0001
Zinc	Yes	17 (34%)	42 (84%)	< 0.0001
Lactoferrin	No	44 (88.0%)	21 (42%)	< 0.0001
Lactoferrin	Yes	6 (12%)	29 (58%)	< 0.0001