Increased levels of ferritin on admission predicts intensive care unit mortality in patients with COVID-19

Deng, Feng; Zhang, Lisha; Lyu, Lyu; Lu, Ziwei; Gao, Dengfeng; Ma, Xiaoli; Guo, Yi; Wang, Rong; Gong, Shengjie; Wei, Jue

doi:10.1016/j.medcli.2020.11.030

Cited by 67 publications

(77 citation statements)

References 26 publications

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“…However, there was no significant difference between the two groups in terms of diseases with high mortality rates such as hypertension, diabetes mellitus, coronary artery disease, chronic obstructive pulmonary disease, malignancy and gender. In addition, as acute phase reactants, low albumin, high CRP and ferritin were statistically significant in the deceased patient group, same as results of previous studies (22,23). In our study, as in previous studies, troponin and d-dimer levels were higher in the patient group who died, and their relationship with mortality was also revealed in this study (24,25).…”

Section: Discussionsupporting

confidence: 92%

The role of ECG as a mortality predictor in COVID-19 patients treated in the intensive care unit

Aydemir

Şahan

2021

Journal of Health Sciences and Medicine

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Background: COVID-19 infection has reached serious morbidity and mortality rates all over the world for a short time. Many studies have investigated the relationship of COVID-19 disease with mortality and morbidity. In this study, we wanted to elucidate the relationship between rhythm character (sinus rhythm vs atrial fibrillation) and QTc and frontal plane QRS-T angle, which parameters are reflecting the depolarization-repolarization kinetics, and mortality, which were not emphasized enough in previous studies. Material and Method: 259 patients admitted to the intensive care unit due to COVID-19 infection between 01.04.2020 and 01.12.2020 was included in the study. The demographic characteristics of the patients, clinical backgrounds, laboratory values at the time of admission to the intensive care unit, and 12 derivation ECG records were obtained from the patient files. Rhythm, PR distance, QRS duration and morphology, QT interval, T wave morphology, presence of atrioventricular (AV) block, QRS axis, presence of ventricular premature contraction, frontal plane QRS-T (f(QRS-T)) angle degree were determined on 12 derivation ECG records. Patient groups were classified as "deceased patient" and "survivors" and the relationship of these parameters with survival was tried to be elucidated. Results: the frequency of atrial fibrillation was significantly higher in the "deceased patient" group. For patients in sinus rhythm, there was no difference between the two groups in terms of PR distance and 1st degree AV block. Severe AV block was not observed in either group. There was no difference between the two groups in terms of QRS morphology, T wave inversion, and ventricular premature contractions. QRS duration, corrected QTc duration, and frotal plane QRS-T angle values were found to be statistically significantly higher in in the "deceased patient" group. Conclusion: Atrial fibrillation, prolonged QTc duration and increased frontal plane QRS-T angle can be considered as mortality predictors in COVID-19 infection whose mortality rate is high all over the world.

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Section: Discussionsupporting

confidence: 92%

The role of ECG as a mortality predictor in COVID-19 patients treated in the intensive care unit

Aydemir

Şahan

2021

Journal of Health Sciences and Medicine

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“…In this cohort, higher serum ferritin was independently associated with mortality after multivariate analysis. Several authors already reported the association between higher serum ferritin and mortality [ 49 , 50 , 51 ]. Many inflammatory biomarkers, such as interleukin (IL)-2, IL-6, IL-10 and tumor necrosis factor, were found higher in COVID-19 patients with severe disease, compared with those with mild or moderate disease [ 52 ].…”

Section: Discussionmentioning

confidence: 99%

Acute Kidney Disease and Mortality in Acute Kidney Injury Patients with COVID-19

Marques

Gameiro

Oliveira

et al. 2021

JCM

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Background: The incidence of AKI in coronavirus disease 2019 (COVID-19) patients is variable and has been associated with worse prognosis. A significant number of patients develop persistent kidney damage defined as Acute Kidney Disease (AKD). There is a lack of evidence on the real impact of AKD on COVID-19 patients. We aim to identify risk factors for the development of AKD and its impact on mortality in COVID-19 patients. Methods: Retrospective analysis of COVID-19 patients with AKI admitted at the Centro Hospitalar Universitário Lisboa Norte between March and August of 2020. The Kidney Disease Improving Global Outcomes (KDIGO) classification was used to define AKI. AKD was defined by presenting at least KDIGO Stage 1 criteria for >7 days after an AKI initiating event. Results: In 339 COVID-19 patients with AKI, 25.7% patients developed AKD (n = 87). The mean age was 71.7 ± 17.0 years, baseline SCr was 1.03 ± 0.44 mg/dL, and the majority of patients were classified as KDIGO stage 3 AKI (54.3%). The in-hospital mortality was 18.0% (n = 61). Presence of hypertension (p = 0.006), CKD (p < 0.001), lower hemoglobin (p = 0.034) and lower CRP (p = 0.004) at the hospital admission and nephrotoxin exposure (p < 0.001) were independent risk factors for the development of AKD. Older age (p = 0.003), higher serum ferritin at admission (p = 0.008) and development of AKD (p = 0.029) were independent predictors of in-hospital mortality in COVID-19-AKI patients. Conclusions: AKD was significantly associated with in-hospital mortality in this population of COVID-19-AKI patients. Considering the significant risk of mortality in AKI patients, it is of paramount importance to identify the subset of higher risk patients.

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“…Hyperferritinemia, due to the profound inflammation, is a characteristic feature of COVID-19 [83] and is associated with increased mortality [84]. Notably, ferritin-associated iron induces defects in innate (neutrophils) and adaptive immunity (T-lymphocytes) in mice models [85,86].…”

Section: Iron Metabolismmentioning

confidence: 99%

Epidemiology and Pathophysiology of COVID-19-Associated Mucormycosis: India Versus the Rest of the World

et al. 2021

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Increased levels of ferritin on admission predicts intensive care unit mortality in patients with COVID-19

Cited by 67 publications

References 26 publications

The role of ECG as a mortality predictor in COVID-19 patients treated in the intensive care unit

The role of ECG as a mortality predictor in COVID-19 patients treated in the intensive care unit

Acute Kidney Disease and Mortality in Acute Kidney Injury Patients with COVID-19

Epidemiology and Pathophysiology of COVID-19-Associated Mucormycosis: India Versus the Rest of the World

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