In recent decades, healthcare has faced the challenge of providing quality care with limited funding. Due to the fact that medical laboratories widely use modern technological solutions, assessing the profitability of the laboratory as a whole and the contribution of each type of cost to measurement are relevant. The direct costs of the test are mainly generated by the costs of reagents and personnel. The high level of automation in large laboratory centres allows increasing the technological efficiency of equipment and significantly reducing the contribution of personnel to doing research. Innovative technology solutions shift the role of the laboratory physician from performing measurement to managing laboratory processes, quality assurance, and medical advice.
Serum ferritin is considered one of the predictors of severe forms of diseases and an increased mortality risk in patients with various diseases. However, the results of the studies performed to date are not heterogeneous and the usefulness of measuring serum ferritin in all inpatients, including those with COVID‑19, is being questioned. The study included the results of measuring serum ferritin in 761 adult patients, of which in the main group 634 were confirmed with COVID‑19, and 127 patients from the comparison group were hospitalized with other diagnoses. Differences in serum ferritin concentration in the main group (COVID‑19 “+”: survivors: Me 295.2, 95% CI: 353.8–449.1 µg/l, non-survivors Me 285.9, 95% CI: 309.9–628.9 µg/l) and in the comparison group (COVID‑19 “-”: survivors Me 267.2: 95% CI 268.2–526.0 µg/l, non-survivors Me 197.7, 95% CI: 110.3–529.0 µg/l) depending on the outcomes of the disease were not statistically significant. At the same time, in the cohort of the non-survivors, serum ferritin above 500 µg/l with COVID‑19 was 23.75 times more common, and in the cohort with a ferritin concentration above 1500 µg/l, 17.75 times more common than ferritin in the group of inpatients without COVID–19. Our results indicate the impracticality of measuring serum ferritin for all inpatients; however, they confirm the fact that selective measurement of serum ferritin in patients with severe course of diseases, especially infectious diseases, makes it possible to identify a category of patients with a high risk of developing hyperinflammation.
There is an ongoing debate about what the laboratory should do with hemolyzed samples. Several strategies are proposed for managing the results obtained in such samples. The safest option from the analytical and clinical points of view is to perform a study of a new sample without hemolysis. Another approach is to carry out a test irregardless, but at the same time indicate a limit on the clinical interpretation of the result, by making a comment on possible hemoglobin interference. The choice of strategy should be based on a comparison of the risk of negative consequences in the absence of a test result and the likelihood of harm due to the transfer of the result with high uncertainty to the clinician.
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