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

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.