Ferritin level predicts in-hospital mortality in hypertensive patients with COVID-19

Abstract

Aim. This study aimed to establish the predictive ability of serum ferritin levels for severe / critical condition development, need for supplemental oxygen, and in-hospital mortality in hypertensive patients with COVID-19-associated pneumonia. Materials and methods. 135 unvaccinated patients hospitalized for COVID-19-associated pneumonia were enrolled in the study. 78.5 % of patients were hypertensive. Results. Among hypertensive patients, the median ferritin level at admission was 315.5 (169.0–396.0) ng/mL in patients with moderate condition, 374.0 (171.0–709.5) ng/mL in patients developed severe condition, and 489.0 (362.0–1128.5) ng/mL in patients developed critical condition (P = 0.03). Serum ferritin level at admission was higher in non-survivors (539.0 (440.0–1128.5) ng/mL) than that in survivors (332.5 (172.0–545.0) ng/mL, P = 0.02). Hypertensive patients who required supplemental oxygen had higher median serum ferritin level (446.0 (187.0–763.0) ng/mL) than patients without the requirement of supplemental oxygen (324.0 (165.0–401.0) ng/mL, P = 0.02). There was poor discrimination ability of ferritin level in the prediction of severe / critical conditions (AUC = 0.628, P = 0.02) and the need for supplemental oxygen (AUC = 0.629, P = 0.02). There was an acceptable discrimination ability of ferritin level in the in-hospital mortality prediction (AUC = 0.701, P = 0.03); the Youden index was 0.54, the associated criterion was >438.0 ng/mL with 83.3 % sensitivity and 70.7 % specificity. Ferritin level >438.0 ng/mL at admission was associated with a significant increase in in-hospital mortality (OR = 12.04 (2.47–58.62), P = 0.002). Conclusions. Serum ferritin level at hospital admission increases with the severity of COVID-19 in hypertensive patients. Serum ferritin level predicts in-hospital mortality in hypertensive patients. However, its predictive ability for the disease progression to severe/critical conditions and the need for supplemental oxygen is poor. A ferritin level of 438.0 ng/mL is proposed to be a cut-off value for the prediction of in-hospital mortality.