Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a pandemic of respiratory and cardiovascular diseases, known as coronavirus disease 2019 (COVID-19). SARS-CoV-2 encodes the structural proteins spike (S), envelope (E), membrane (M), and nucleocapsid (N). The receptor-binding domain on the surface subunit S1 is responsible for attachment of the virus to angiotensin (Ang)-converting enzyme 2 (ACE2), which is highly expressed in host cells. The cytokine storm observed in patients with COVID-19 contributes to the endothelial vascular dysfunction, which can lead to acute respiratory distress syndrome, multiorgan failure, alteration in iron homeostasis, and death. Growth and differentiation factor 15 (GDF15), which belongs to the transforming growth factor-β (TGF-β) superfamily of proteins, has a pivotal role in the development and progression of diseases because of its role as a metabolic regulator. In COVID-19, GDF15 activity increases in response to tissue damage. GDF15 appears to be a strong predictor of poor outcomes in patients critically ill with COVID-19 and acts as an ‘inflammation-induced central mediator of tissue tolerance’ via its metabolic properties. In this review, we examine the potential properties of GDF15 as an emerging modulator of immunity in COVID-19 in association with iron metabolism. The virus life cycle in host cell provides potential targets for drug therapy.

严重急性呼吸系统综合症冠状病毒 2 (SARS-CoV-2) 已引起呼吸道和心血管疾病大流行，即 2019 冠状病毒病 (COVID-19)。SARS-CoV-2 编码结构蛋白刺突 (S)、包膜 (E)、膜 (M) 和核衣壳 (N)。表面亚基 S1 上的受体结合域负责病毒与血管紧张素 (Ang) 转换酶 2 (ACE2) 的结合，后者在宿主细胞中高度表达。在 COVID-19 患者中观察到的细胞因子风暴会导致内皮血管功能障碍，从而导致急性呼吸窘迫综合征、多器官衰竭、铁稳态改变和死亡。生长和分化因子 15 (GDF15)，属于蛋白质的转化生长因子-β (TGF-β) 超家族，由于其作为代谢调节剂的作用，在疾病的发生和发展中起着举足轻重的作用。在 COVID-19 中，GDF15 活性随着组织损伤而增加。GDF15 似乎是 COVID-19 重症患者不良预后的有力预测因子，并通过其代谢特性充当“炎症诱导的组织耐受性中枢介质”。在这篇综述中，我们研究了 GDF15 作为 COVID-19 中与铁代谢相关的新兴免疫调节剂的潜在特性。宿主细胞中的病毒生命周期为药物治疗提供了潜在靶点。GDF15 似乎是 COVID-19 重症患者不良预后的有力预测因子，并通过其代谢特性充当“炎症诱导的组织耐受性中枢介质”。在这篇综述中，我们研究了 GDF15 作为 COVID-19 中与铁代谢相关的新兴免疫调节剂的潜在特性。宿主细胞中的病毒生命周期为药物治疗提供了潜在靶点。GDF15 似乎是 COVID-19 重症患者不良预后的有力预测因子，并通过其代谢特性充当“炎症诱导的组织耐受性中枢介质”。在这篇综述中，我们研究了 GDF15 作为 COVID-19 中与铁代谢相关的新兴免疫调节剂的潜在特性。宿主细胞中的病毒生命周期为药物治疗提供了潜在靶点。