Can Ferritin Levels Predict the Severity of Illness in Patients With COVID-19?

Firdevs Tugba Bozkurt; Mehmet Tercan; Gulcin Patmano; Tugba Bingol Tanrıverdi; Huseyin Avni Demir; Ugur Fahri Yurekli

doi:10.7759/cureus.12832

Can Ferritin Levels Predict the Severity of Illness in Patients With COVID-19?

Cureus. 2021 Jan 21;13(1):e12832. doi: 10.7759/cureus.12832.

Authors

Firdevs Tugba Bozkurt¹, Mehmet Tercan², Gulcin Patmano², Tugba Bingol Tanrıverdi², Huseyin Avni Demir³, Ugur Fahri Yurekli⁴

Affiliations

¹ Intensive Care Unit, University of Health Sciences, Şanlıurfa Mehmet Akif İnan Research and Training Hospital, Şanlıurfa, TUR.
² Department of Anesthesiology and Reanimation, University of Health Sciences, Şanlıurfa Mehmet Akif İnan Research and Training Hospital, Şanlıurfa, TUR.
³ Department of Emergency Medicine, University of Health Sciences, Şanlıurfa Mehmet Akif İnan Research and Training Hospital, Şanlıurfa, TUR.
⁴ Department of Biochemistry, University of Health Sciences, Şanlıurfa Mehmet Akif İnan Research and Training Hospital, Şanlıurfa, TUR.

Abstract

Objectives: This study aimed to investigate whether ferritin level can predict the severity of coronavirus disease 2019 (COVID-19).

Background: The COVID-19 pandemic has been challenging for both patients and caregivers. Many laboratory markers have been used to better understand the causes of poor outcomes and to improve the management of COVID-19 patients.

Methods: A total of 93 patients who had a positive polymerase chain reaction test result for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were included in this study. Demographic features, comorbidities, clinical and laboratory findings were obtained from the hospital database retrospectively. Patients were divided into two groups according to the disease severity as follows: mild group (n = 70) and severe group (n = 23).

Results: The median age of the study population was 42.5 (28.3-62.8) with 69.9% male patients. Patients in the severe group were significantly older and showed a higher frequency of hypertension, diabetes mellitus, coronary artery disease, and heart failure in comparison with those in the mild group. In addition, gamma-glutamyl transferase, C-reactive protein, ferritin, interleukin-6, procalcitonin, and neutrophil to lymphocyte ratio were higher whereas albumin level was lower in patients in the severe group. Linear regression analysis demonstrated that ferritin level was the only significant predictor of disease severity (β = 0.487, t = 2.993, p = 0.004). In receiver operator characteristics curve analysis, ferritin level ≥264.5 ng/mL predicted severe COVID-19 with a sensitivity of 73.9% and specificity of 94.2%.

Conclusion: Early analysis of ferritin levels in patients with COVID-19 might effectively predict the disease severity.

Keywords: coronavirus; disease severity; ferritin; pandemic.