Association between HLA genotype and ferritin levels in COVID-19 infection: a study of a Saudi cohort.

Background: An elevation in serum ferritin levels through an unknown mechanism was observed in COVID-19 infected patients. This study examined the association between patients' HLA genotype and serum ferritin level modulation and also assessed the effect of serum ferritin levels on infection severity/mortality.

Materials And Methods: One hundred and thirty-six COVID-19 Saudi patients were divided into two groups according to their ferritin levels: group 1 (<500 ng/mL,  = 67) and group 2 (>500 ng/mL,  = 69). HLA genotyping (class I and II) was carried out through the rPCR-SSO method.

Results: High serum ferritin levels were associated with a significant increase in infection severity, as 75% of ICU patients showed high levels of ferritin compared to 43% of patients with moderate symptoms,  = .002. This elevation indicated a gender skew in that 56% of the infected male patients displayed high ferritin levels compared to 36.6% of the female patients,  = .03. In terms of mortality, 74% of patients with fatal outcomes had a high level of serum ferritin compared to 47% of recovered patients,  = .039. There was a significant difference in the HLA frequency between the two groups, with a predominance of HLA-A*01 in the low-ferritin group (19.4 6.5%,  = .002, = .016) and predominance of C*03 in the high ferritin group (10.9 3%,  = .047, = .27).

Conclusion: High serum ferritin levels are associated with an increase in COVID-19 severity, which may be affected by HLA polymorphism.