Introduction The COVID-19 pneumonia is a heterogeneous disease with variable effect on lung parenchyma, airways, and vasculature leading to long-term effects on lung functions. Materials and methods Multicentric, prospective, observational, and interventional study conducted during July 2020 to May 2021, in the MIMSR Medical College and Venkatesh Hospital Latur India, included 1000 COVID-19 cases confirmed with RT-PCR. All cases were assessed with lung involvement documented and categorized on HRCT thorax, oxygen saturation, inflammatory marker, ferritin at entry point, and follow-up during hospitalization. Age, gender, comorbidity, and use of BIPAP/NIV and outcome as with or without lung fibrosis as per CT severity were key observations. CT severity scoring is done as per universally accepted standard scoring tool as score < 7 as mild, 7–14 as moderate, and score > 15 as severe affection of the lung. Statistical analysis is done by using chi-square test. Observations and analysis In study of 1000 COVID-19 pneumonia cases, age (< 50 and > 50 years) and gender (male versus female) have significant association with ferritin in predicting severity of COVID-19 pneumonia (p < 0.00001) and (p < 0.010), respectively. CT severity score at entry point with ferritin level has significant correlation in severity scores < 8, 8–15, and > 15 documented in normal and abnormal ferritin level as in 190/110, 90/210, and 40/360, respectively (p < 0.00001). Ferritin level has significant association with duration of illness, i.e., DOI < 7 days, 8–15 days, and > 15 days of onset of symptoms documented normal and abnormal ferritin levels in 30/310, 160/300, and 130/70 cases, respectively (p < 0.00001). Comorbidity as diabetes mellitus, hypertension, COPD, IHD, and obesity has significant association in COVID-19 cases with normal and abnormal ferritin level respectively (p < 0.00001). Ferritin level has significant association with oxygen saturation in COVID-19 pneumonia cases; cases with oxygen saturation > 90%, 75–90%, and < 75% are observed as normal and abnormal ferritin level in 110/100, 150/340, and 60/240 cases, respectively (p < 0.00001). BIPAP/NIV requirement during the course of COVID-19 pneumonia in critical care setting has significant association with ferritin level; cases received BIPAP/NIV during hospitalization were documented normal and abnormal ferritin level in 155/445 and 165/235 cases, respectively (p < 0.00001). Timing of BIPAP/NIV requirement during course of COVID-19 pneumonia in critical care setting has significant association with ferritin level; cases received BIPAP/NIV at entry point < 1 day, 3–7 days, and after 7 days of hospitalization were documented significance in fourfold raised ferritin level in 110/70, 150/160, and 30/80 cases, respectively (p < 0.00001). Follow-up of ferritin titer during hospitalization as compared to entry point abnormal ferritin has significant association in post-COVID lung fibrosis (p < 0.00001). Follow-up of ferritin titer during hospitalization as compared to entry point normal ferritin has significant association in post-COVID lung fibrosis (p < 0.00001). Conclusion Ferritin is easily available, sensitive and reliable, cost-effective, and universally acceptable inflammatory marker in COVID-19 pandemic. Ferritin has very crucial role in COVID-19 pneumonia in predicting severity of illness and assessing response to treatment during hospitalization. Follow-up of ferritin titer during hospitalization and at discharge can be used as early predictor of post-COVID lung fibrosis.

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Aims and Objectives: Robust data of ferritin are available as a prognostic marker in bacterial infection and we have analyzed its usefulness in coronavirus disease 2019 (COVID-19) pneumonia in predicting severity of illness, response to treatment, and final outcome. Materials and Methods: A multicentric, prospective, observational, and interventional study included 1000 COVID-19 cases confirmed with reverse transcription–polymerase chain reaction. All cases were assessed with lung involvement documented and categorized on high-resolution computed tomography (CT) thorax, oxygen saturation, inflammatory marker, ferritin at entry point, and follow-up during hospitalization. Age, gender, comorbidity and use of BIPAP (bilevel positive airway pressure)/NIV (non-invasive ventilation) /NIV, and outcome as with or without lung fibrosis as per CT severity were key observations. Statistical analysis was done using Chi-square test. Observations and Analysis: In a study of 1000 COVID-19 pneumonia cases, age (<50 and > 50 years) and gender (male versus female) had a significant association with ferritin (P < 0.00001 and P < 0.010, respectively). CT severity score at entry point with ferritin level had a significant correlation in severity score (P < 0.00001). Ferritin level had a significant association with duration of illness (P < 0.00001). Comorbidities had a significant association with ferritin level (P < 0.00001). Ferritin level had a significant association with oxygen saturation (P < 0.00001). BIPAP/NIV during hospitalization had a significant association with ferritin level (P < 0.00001). Timing of BIPAP/NIV requirement in critical care setting had a significant association with ferritin level (P < 0.00001). Follow-up ferritin titer during hospitalization as compared to entry point normal and abnormal ferritin had a significant association in post-COVID lung fibrosis, respectively (P < 0.00001). Conclusions: Ferritin has documented very crucial role in COVID-19 pneumonia in predicting severity of illness, progression of illness and requirement of mechanical ventilation, assessing response to treatment during hospitalization. Follow up ferritin titre during hospitalization and at discharge can be used as early predictor of post-covid lung fibrosis.

Lung function impairment is known to occur after pulmonary TB irrespective of duration of treatment and outcome of disease. Obstructive lung disease is the predominant lung function impairment in symptomatic cases. Significant number of asymptomatic cases are also having obstructive pattern of lung function in spirometry analysis.