Association of serum ferritin with severity and clinical outcome in COVID-19 patients: An observational study in a tertiary healthcare facility
Background: Ferritin, an intracellular protein, has a pivotal role in immune dysregulation. Hyperferritinemia has been associated with higher disease severity and adverse clinical outcomes in COVID-19, including mortality. We aimed to study the association of serum ferritin levels with disease sever...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-05-01
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| Series: | Clinical Epidemiology and Global Health |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213398423000829 |
| _version_ | 1827923360661635072 |
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| author | Shilia Jacob Kurian Sara Poikayil Mathews Abin Paul Subeesh K. Viswam Shivashankara Kaniyoor Nagri Sonal Sekhar Miraj Shubhada Karanth |
| author_facet | Shilia Jacob Kurian Sara Poikayil Mathews Abin Paul Subeesh K. Viswam Shivashankara Kaniyoor Nagri Sonal Sekhar Miraj Shubhada Karanth |
| author_sort | Shilia Jacob Kurian |
| collection | DOAJ |
| description | Background: Ferritin, an intracellular protein, has a pivotal role in immune dysregulation. Hyperferritinemia has been associated with higher disease severity and adverse clinical outcomes in COVID-19, including mortality. We aimed to study the association of serum ferritin levels with disease severity and clinical outcomes and its severity prediction potential in COVID-19 patients. Methods: This retrospective study included 870 adult patients with symptomatic COVID-19 infection hospitalized between July 1, 2020 to December 21, 2020. All the patients had a positive polymerase chain reaction test result of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Results: The median age was 55 (IQR:40, 65) years with a male predominance [66.32% (n = 577)], among 870 COVID-19. Of these, 413 (47.47%) had mild COVID-19, and 457 (52.53%) had moderate plus severe COVID-19 disease. Median ferritin levels were significantly high in moderate to severe COVID-19 infection compared to mild [545.8 (326.0, 1046.0) vs 97.3 (52.65–155.5) (p = 0.001)], and in patients who developed a complication compared to without complications [380 (177.05, 863.15) vs 290 (110.9, 635) (p = 0.002). A slight elevation in median ferritin levels was observed in patients who had an ICU stay than non-ICU [326 (129.8, 655) vs 309 (119.1, 684) (p = 0.872)]. The cut-off for ferritin was identified at >287.4 ng/ml for mild versus moderate plus severe COVID-19 infections. Conclusion: Moderate to severe COVID-19 patients have elevated ferritin levels. Patients with more than 287.4 ng/ml ferritin value would have greater chances of developing moderate to severe COVID-19 infections. |
| first_indexed | 2024-03-13T04:55:39Z |
| format | Article |
| id | doaj.art-7a3ed63fc1be465686d6882052e83d9a |
| institution | Directory Open Access Journal |
| issn | 2213-3984 |
| language | English |
| last_indexed | 2024-03-13T04:55:39Z |
| publishDate | 2023-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Clinical Epidemiology and Global Health |
| spelling | doaj.art-7a3ed63fc1be465686d6882052e83d9a2023-06-18T05:01:45ZengElsevierClinical Epidemiology and Global Health2213-39842023-05-0121101295Association of serum ferritin with severity and clinical outcome in COVID-19 patients: An observational study in a tertiary healthcare facilityShilia Jacob Kurian0Sara Poikayil Mathews1Abin Paul2Subeesh K. Viswam3Shivashankara Kaniyoor Nagri4Sonal Sekhar Miraj5Shubhada Karanth6Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, IndiaDepartment of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, IndiaDepartment of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, IndiaDepartment of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, IndiaDepartment of Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, IndiaDepartment of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, IndiaDepartment of Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India; Corresponding author.Background: Ferritin, an intracellular protein, has a pivotal role in immune dysregulation. Hyperferritinemia has been associated with higher disease severity and adverse clinical outcomes in COVID-19, including mortality. We aimed to study the association of serum ferritin levels with disease severity and clinical outcomes and its severity prediction potential in COVID-19 patients. Methods: This retrospective study included 870 adult patients with symptomatic COVID-19 infection hospitalized between July 1, 2020 to December 21, 2020. All the patients had a positive polymerase chain reaction test result of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Results: The median age was 55 (IQR:40, 65) years with a male predominance [66.32% (n = 577)], among 870 COVID-19. Of these, 413 (47.47%) had mild COVID-19, and 457 (52.53%) had moderate plus severe COVID-19 disease. Median ferritin levels were significantly high in moderate to severe COVID-19 infection compared to mild [545.8 (326.0, 1046.0) vs 97.3 (52.65–155.5) (p = 0.001)], and in patients who developed a complication compared to without complications [380 (177.05, 863.15) vs 290 (110.9, 635) (p = 0.002). A slight elevation in median ferritin levels was observed in patients who had an ICU stay than non-ICU [326 (129.8, 655) vs 309 (119.1, 684) (p = 0.872)]. The cut-off for ferritin was identified at >287.4 ng/ml for mild versus moderate plus severe COVID-19 infections. Conclusion: Moderate to severe COVID-19 patients have elevated ferritin levels. Patients with more than 287.4 ng/ml ferritin value would have greater chances of developing moderate to severe COVID-19 infections.http://www.sciencedirect.com/science/article/pii/S2213398423000829COVID-19FerritinRisk factorSARS-CoV-2Severity |
| spellingShingle | Shilia Jacob Kurian Sara Poikayil Mathews Abin Paul Subeesh K. Viswam Shivashankara Kaniyoor Nagri Sonal Sekhar Miraj Shubhada Karanth Association of serum ferritin with severity and clinical outcome in COVID-19 patients: An observational study in a tertiary healthcare facility Clinical Epidemiology and Global Health COVID-19 Ferritin Risk factor SARS-CoV-2 Severity |
| title | Association of serum ferritin with severity and clinical outcome in COVID-19 patients: An observational study in a tertiary healthcare facility |
| title_full | Association of serum ferritin with severity and clinical outcome in COVID-19 patients: An observational study in a tertiary healthcare facility |
| title_fullStr | Association of serum ferritin with severity and clinical outcome in COVID-19 patients: An observational study in a tertiary healthcare facility |
| title_full_unstemmed | Association of serum ferritin with severity and clinical outcome in COVID-19 patients: An observational study in a tertiary healthcare facility |
| title_short | Association of serum ferritin with severity and clinical outcome in COVID-19 patients: An observational study in a tertiary healthcare facility |
| title_sort | association of serum ferritin with severity and clinical outcome in covid 19 patients an observational study in a tertiary healthcare facility |
| topic | COVID-19 Ferritin Risk factor SARS-CoV-2 Severity |
| url | http://www.sciencedirect.com/science/article/pii/S2213398423000829 |
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