Serum ferritin as a predictive biomarker in COVID-19. A systematic review, meta-analysis and meta-regression analysis

Kaushal, Kanica; Kaur, Hardeep; Sarma, Phulen; Bhattacharyya, Anusuya; Sharma, Dibya Jyoti; Prajapat, Manisha; Pathak, Mona; Kothari, Ashish; Kumar, Subodh; Rana, Satyavati; Kaur, Manpreet; Prakash, Ajay; Mirza, Anissa Atif; Panda, Prasan Kumar; Vivekanandan, Sindu; Omar, Balram Ji; Medhi, Bikash; Naithani, Manisha

doi:10.1016/j.jcrc.2021.09.023

Cited by 89 publications

(54 citation statements)

References 42 publications

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“…Alteration of iron metabolism occurs in severe COVID-19[ 44 ] and iron overload (excessive free iron seen in acidosis) are other established risk factors for opportunistic fungal infection. [ 47 48 ] However, none of the included in our meta-analysis has reported or gave specific consideration in this aspect.…”

Section: Discussionmentioning

confidence: 99%

COVID-19–associated rhino-orbital-cerebral mucormycosis: A systematic review, meta-analysis, and meta-regression analysis

et al. 2021

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BACKGROUND: Till now, no meta-analysis is available to address the clinical profile, risk factors, different interventions, and outcomes among COVID-19–associated rhino-orbito-cerebral mucormycosis (C-ROCM) cases. MATERIALS AND METHODS: Eight literature databases were screened using appropriate keywords from November 1, 2019, to June 30, 2021. The objectives were to analyze the clinical and microbiological profile, risk factor/comorbidity, intervention, and outcome. “R-metafor package” was used for analysis. RESULTS: A total of 23 studies were included. The mean age of presentation of C-ROCM was 54.6 years. The most common presentation was ptosis (72.7%), lid edema (60.6%), proptosis (60.6%), ophthalmoplegia (57.3%), loss of vision (53.7%), facial edema (34.7%), and nasal-blockage (11.8%). Evidence of intracranial spread was seen in 42.8% of cases. Rhizopus was the most common fungus (57.1%) isolated in fungal culture. Among C-ROCM patients, diabetes was the commonest comorbid condition, and the use of corticosteroids related to COVID-19 treatment was the most common risk factor (85.75%). Compared to controlled diabetics, C-ROCM was significantly higher among uncontrolled diabetics (odds ratio [OR] 0.15, 95% confidence interval [C.I.] 0.041–0.544, P = 0.0010). However, no significant association was seen between C-ROCM and COVID-19 severity (OR 0.930, 95% C.I. 0.212–4.087, P = 0.923). For treatment, amphotericin-B was the most common antifungal drug used which was followed by surgical options. However, mortality was high (prevalence 0.344, 95% C.I. 0.205–0.403) despite treatment. CONCLUSION: Although local rhino-orbito symptoms were the first to appear, rapid intracranial extension was seen in a significant number of C-ROCM cases. Uncontrolled diabetes and excessive use of corticosteroid were the most common risk factors present among the C-ROCM cases. High index clinical suspicion is imperative (specifically among COVID-19 patients with diabetes), and routine screening may be helpful.

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Section: Discussionmentioning

confidence: 99%

COVID-19–associated rhino-orbital-cerebral mucormycosis: A systematic review, meta-analysis, and meta-regression analysis

et al. 2021

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“…Elevated ferritin serum levels have been found to significantly correlate with COVID-19 severity, as discussed in these papers (Lin et al, 2020; Carubbi et al, 2021; Ahmed et al, 2021; Kaushal et al, 2022), among others.…”

Section: Discussionmentioning

confidence: 68%

A Composite Ranking of Risk Factors for COVID-19 Time-To-Event Data from a Turkish Cohort

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et al. 2022

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Having a complete and reliable list of risk factors from routine laboratory blood test for COVID-19 disease severity and mortality is important for patient care and hospital management. It is common to use meta-analysis to combine analysis results from different studies to make it more reproducible. In this paper, we propose to run multiple analyses on the same set of data to produce a more robust list of risk factors. With our time-to-event survival data, the standard survival analysis were extended in three directions. The first is to extend from tests and corresponding p-values to machine learning and their prediction performance. The second is to extend from single-variable to multiple-variable analysis. The third is to expand from analyzing time-to-decease data with death as the event of interest to analyzing time-to-hospital-release data to treat early recover as a meaningful event as well. Our extension of the type of analyses leads to ten ranking lists. We conclude that 20 out of 30 factors are deemed to be reliably associated to faster-death or faster-recovery. Considering correlation among factors and evidenced by stepwise variable selection in random survival forest, 10~15 factors seem to be able to achieve the optimal prognosis performance. Our final list of risk factors contains calcium, white blood cell and neutrophils count, urea and creatine, d-dimer, red cell distribution widths, age, ferritin, glucose, lactate dehydrogenase, lymphocyte, basophils, anemia related factors (hemoglobin, hematocrit, mean corpuscular hemoglobin concentration), sodium, potassium, eosinophils, and aspartate aminotransferase.

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“…( Williamson et al, 2020) . Elevated ferritin serum levels have been found to significantly correlate with COVID-19 severity, as discussed in these papers ( Lin et al, 2020 , Carubbi et al, 2021 , Ahmed et al, 2021 , Kaushal et al, 2022 , among others. The short-term glucose has been shown to be a much stronger predictor for COVID-19 severity than the history of diabetes status ( Singh and Singh, 2020 , Coppelli et al, 2020 , Ling et al, 2020 , Cetin et al, 2021d , Guarisco et al, 2022 .…”

Section: Discussionmentioning

confidence: 74%

“…Elevated ferritin serum levels have been found to significantly correlate with COVID-19 severity, as discussed in these papers ( Lin et al, 2020 , Carubbi et al, 2021 , Ahmed et al, 2021 , Kaushal et al, 2022 , among others.…”

Section: Discussionmentioning

confidence: 74%

A composite ranking of risk factors for COVID-19 time-to-event data from a Turkish cohort

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Çetin

et al. 2022

Computational Biology and Chemistry

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Serum ferritin as a predictive biomarker in COVID-19. A systematic review, meta-analysis and meta-regression analysis

Cited by 89 publications

References 42 publications

COVID-19–associated rhino-orbital-cerebral mucormycosis: A systematic review, meta-analysis, and meta-regression analysis

COVID-19–associated rhino-orbital-cerebral mucormycosis: A systematic review, meta-analysis, and meta-regression analysis

A Composite Ranking of Risk Factors for COVID-19 Time-To-Event Data from a Turkish Cohort

A composite ranking of risk factors for COVID-19 time-to-event data from a Turkish cohort

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