Association of serum ferritin with severity and clinical outcome in COVID-19 patients: An observational study in a tertiary healthcare facility

Kurian, Shilia Jacob; Mathews, Sara Poikayil; Paul, A.; Viswam, Subeesh K.; Shivashankar, K N; Miraj, Sonal Sekhar; Karanth, Shubhada

doi:10.1016/j.cegh.2023.101295

Cited by 14 publications

(7 citation statements)

References 26 publications

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“…Hyperferritinemia, caused by excessive inflammation, is associated with admission to the intensive care unit and high mortality, and represents an indication to recognize high-risk patients. It is also present in patients with comorbidities [ 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

COVID-19 Biomarkers Comparison: Children, Adults and Elders

et al. 2023

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Background and Objectives: this study aimed to research links between C-reactive protein (CRP), lactate dehydrogenase (LDH), creatinekinase (CK), 25-OH vitamin D (25-OHD), ferritin (FER), high-density lipoprotein cholesterol (HDL)cholesterol and clinical severity in patients from the western part of Romania, and compare their potential use as biomarkers for intensive care units (ICU) admission and death in children, adults and elders. Materials and Methods: this study is a retrospective cohort study, performed on patients positively diagnosed with COVID-19. Available CRP, LDH, CK 25-OH vitamin D, ferritin, HDL cholesterol and clinical severity were recorded. The following were assessed: median group differences, association, correlation and receiver operating characteristic. Results: 381 children, 614 adults and 381 elders were studied between 1 March 2021 and 1 March 2022. Most children and adults presented mild symptomatology (53.28%, 35.02%, respectively), while most elders presented severe symptomatology (30.04%). ICU admission was 3.67% for children, 13.19% for adults and 46.09% for elders, while mortality was 0.79% for children, 8.63% for adults and 25.1% for elders. With the exception of CK, all other biomarkers showed some significant associations with clinical severity, ICU admission and death. Conclusions: CRP, LDH, 25-OH vitamin D, ferritin and HDL are important biomarkers for COVID-19 positive patients, especially in the pediatric population, while CK was mostly within normal ranges.

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Section: Introductionmentioning

confidence: 99%

COVID-19 Biomarkers Comparison: Children, Adults and Elders

et al. 2023

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“…In serum, ferritin level is usually regulated by various factors including iron imbalance, hormones and inflammatory cytokines 3 . Researches showed that serum ferritin not only could be an indicator for differentiating anemia 4 , but also was associated with numerous other diseases including malignant tumor 5 , metabolic syndrome 6 , digestive disease 7 and even COVID-19 8 .…”

Section: Introductionmentioning

confidence: 99%

The relationship between serum ferritin level and clinical outcomes in sepsis based on a large public database

Guo

et al. 2023

Sci Rep

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This study aimed to investigate the relationship between serum ferritin level and prognosis in sepsis. It also explored the potential prognostic value of serum ferritin for predicting outcomes in sepsis based on a large public database. Sepsis patients in MIMIC-IV database were included. Different models including crude model (adjusted for none), model I (adjusted for age and gender) and model II (adjusted for all potential confounders) were performed. Smooth fitting curves were constructed for exploring the relationships between serum ferritin and mortalities of 28-day, 90-day, 180-day and 1-year. Receiver operator characteristic (ROC) curve analysis was utilized for assessing the predictive value of serum ferritin. 1947 sepsis patients were included. The mortalities of 28-day, 90-day, 180-day and 1-year were 20.18% (n = 393), 28.35% (n = 552), 30.30% (n = 590) and 31.54% (n = 614), respectively. In Model II (adjusted for all potential confounders), for every 1000 ng/ml increment in serum ferritin, the values of OR in mortalities of in 28-day, 90-day, 180-day and 1-year were 1.13 (95% CI 1.07–1.19, P < 0.0001), 1.15 (95% CI 1.09–1.21, P < 0.0001), 1.16 (95% CI 1.10–1.22, P < 0.0001) and 1.17 (95% CI 1.10–1.23, P < 0.0001), respectively. The relationships between serum ferritin level and outcomes were non-linear. The areas under the ROC curve (AUC) of ferritin for predicting mortalities of 28-day, 90-day, 180-day and 1-year were 0.597 (95% CI 0.563–0.629), 0.593 (95% CI 0.564–0.621), 0.595 (95% CI 0.567–0.623) and 0.592 (95% CI 0.564–0.620), respectively. The non-linear relationships between serum ferritin and clinical outcomes in sepsis were found. Serum ferritin had a predictive value for short-term and long-term outcomes in sepsis.

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“…Enhanced ferritin was also reported in severe-through-critical events compared to moderate-throughmild cases [8], which corroborated the observations of the current study. Evidence suggests that the higher ferritin level was significantly allied with the increased ferritin concentration in HS compared to MS, complicated in comparison to uncomplicated, and intensivecare-unit (ICU) through non-ICU events/cases [3,23]. In addition, high in-hospital death rates and severe pneumonia were significantly associated with ferritin higher than a thousand units [40].…”

Section: Discussionmentioning

confidence: 99%

“…CRP has been recognized as the outcome predictor and discriminator of COVID-19 disease severity [21], and therefore its population-specific measurement encompasses the diagnostic/prognostic value for the disease, COVID-19, and may have a remarkable clinical impact [22]. Raised systemic ferritin level is an indicator of the acute phase and inflammatory response [23]. Hyperferritinemia due to excessive inflammatory response is associated with high mortality [24] and the need for direct therapeutic intervention to control inflammatory cascade [25].…”

Section: Introductionmentioning

confidence: 99%

Association of Coagulopathy and Inflammatory Biomarkers with Severity in SARS-CoV-2-Infected Individuals of the Al-Qunfudhah Region of Saudi Arabia

Izhari,

Hadadi,

Alharbi

et al. 2024

Healthcare

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Background: Identifying prognosticators/predictors of COVID-19 severity is the principal focus for early prediction and effective management of the disease in a time-bound and cost-effective manner. We aimed to evaluate COVID-19 severity-dependent alteration in inflammatory and coagulopathy biomarkers. Methods: A hospital-dependent retrospective observational study (total: n = 377; male, n = 213; and female, n = 164 participants) was undertaken. COVID-19 exposure was assessed by performing real-time PCR on nasopharyngeal (NP) swabs. Descriptive and inferential statistics were applied for both continuous and categorical variables using Rstudio-version-4.0.2. Pearson correlation and regression were executed with a cut-off of p < 0.05 for evaluating significance. Data representation by R-packages and ggplot2. Results: A significant variation in the mean ± SD (highly-sever (HS)/moderately severe (MS)) of CRP (HS/MS: 102.4 ± 22.9/21.3 ± 6.9, p-value < 0.001), D-dimer (HS/MS: 661.1 ± 80.6/348.7 ± 42.9, p-value < 0.001), and ferritin (HS/MS: 875.8 ± 126.8/593.4 ± 67.3, p-value < 0.001) were observed. Thrombocytopenia, high PT, and PTT exhibited an association with the HS individuals (p < 0.001). CRP was correlated with neutrophil (r = 0.77), ferritin (r = 0.74), and WBC (r = 0.8). D-dimer correlated with platelets (r = −0.82), PT (r = 0.22), and PTT (r = 0.37). The adjusted odds ratios (Ad-OR) of CRP, ferritin, D-dimer, platelet, PT, and PTT for HS compared to MS were 1.30 (95% CI −1.137, 1.50; p < 0.001), 1.048 (95% CI −1.03, 1.066; p < 0.001), 1.3 (95% CI −1.24, 1.49, p > 0.05), −0.813 (95% CI −0.734, 0.899, p < 0.001), 1.347 (95% CI −1.15, 1.57, p < 0.001), and 1.234 (95% CI −1.16, 1.314, p < 0.001), respectively. Conclusion: SARS-CoV-2 caused alterations in vital laboratory parameters and raised ferritin, CRP, and D-dimer presented an association with disease severity at a significant level.

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Association of serum ferritin with severity and clinical outcome in COVID-19 patients: An observational study in a tertiary healthcare facility

Cited by 14 publications

References 26 publications

COVID-19 Biomarkers Comparison: Children, Adults and Elders

COVID-19 Biomarkers Comparison: Children, Adults and Elders

The relationship between serum ferritin level and clinical outcomes in sepsis based on a large public database

Association of Coagulopathy and Inflammatory Biomarkers with Severity in SARS-CoV-2-Infected Individuals of the Al-Qunfudhah Region of Saudi Arabia

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