Serum ferritin at admission in hospitalized COVID-19 patients as a predictor of mortality

Lino, Katia; Guimarães, Gabriel Macedo Costa; Alves, Lilian Santos; Oliveira, Any Caroline; Faustino, Renan; Souza, Cintia Fernandes; Tupinambá, Gleiser; Medeiros, Thalia; Silva, Andréa Alice; Almeida, Jorge Reis

doi:10.1016/j.bjid.2021.101569

Cited by 56 publications

(50 citation statements)

References 19 publications

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“…In this cohort, higher serum ferritin was independently associated with mortality after multivariate analysis. Several authors already reported the association between higher serum ferritin and mortality [ 49 , 50 , 51 ]. Many inflammatory biomarkers, such as interleukin (IL)-2, IL-6, IL-10 and tumor necrosis factor, were found higher in COVID-19 patients with severe disease, compared with those with mild or moderate disease [ 52 ].…”

Section: Discussionmentioning

confidence: 99%

Acute Kidney Disease and Mortality in Acute Kidney Injury Patients with COVID-19

Marques

Gameiro

Oliveira

et al. 2021

JCM

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Background: The incidence of AKI in coronavirus disease 2019 (COVID-19) patients is variable and has been associated with worse prognosis. A significant number of patients develop persistent kidney damage defined as Acute Kidney Disease (AKD). There is a lack of evidence on the real impact of AKD on COVID-19 patients. We aim to identify risk factors for the development of AKD and its impact on mortality in COVID-19 patients. Methods: Retrospective analysis of COVID-19 patients with AKI admitted at the Centro Hospitalar Universitário Lisboa Norte between March and August of 2020. The Kidney Disease Improving Global Outcomes (KDIGO) classification was used to define AKI. AKD was defined by presenting at least KDIGO Stage 1 criteria for >7 days after an AKI initiating event. Results: In 339 COVID-19 patients with AKI, 25.7% patients developed AKD (n = 87). The mean age was 71.7 ± 17.0 years, baseline SCr was 1.03 ± 0.44 mg/dL, and the majority of patients were classified as KDIGO stage 3 AKI (54.3%). The in-hospital mortality was 18.0% (n = 61). Presence of hypertension (p = 0.006), CKD (p < 0.001), lower hemoglobin (p = 0.034) and lower CRP (p = 0.004) at the hospital admission and nephrotoxin exposure (p < 0.001) were independent risk factors for the development of AKD. Older age (p = 0.003), higher serum ferritin at admission (p = 0.008) and development of AKD (p = 0.029) were independent predictors of in-hospital mortality in COVID-19-AKI patients. Conclusions: AKD was significantly associated with in-hospital mortality in this population of COVID-19-AKI patients. Considering the significant risk of mortality in AKI patients, it is of paramount importance to identify the subset of higher risk patients.

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Section: Discussionmentioning

confidence: 99%

Acute Kidney Disease and Mortality in Acute Kidney Injury Patients with COVID-19

Marques

Gameiro

Oliveira

et al. 2021

JCM

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“…One of the systemic manifestations of this inflammatory process is an increase in acute-phase proteins, such as CRP and ferritin. 24 CRP, which is produced by the liver, increases in infection, inflammation, and cardiovascular diseases. 25 A meta-analysis by Huang et al elucidated that elevated CRP levels were associated with severe COVID-19 disease and the need for intensive care unit (ICU) admission.…”

Section: Discussionmentioning

confidence: 99%

Coagulation profile and correlation between D-dimer, inflammatory markers, and COVID-19 severity in an Indonesian national referral hospital

Sukrisman

Sinto

2021

J Int Med Res

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Background Coagulopathy and inflammation are associated with coronavirus disease 2019 (COVID-19) severity. This study assessed D-dimer concentration and its correlation with inflammatory markers and COVID-19 severity. Methods This was a retrospective cross-sectional study involving 194 COVID-19 cases, with the severity of infection graded in accordance with the World Health Organization (WHO) guidelines. We measured D-dimer, C-reactive protein (CRP), and ferritin on admission and determined the cutoff values for D-dimer and CRP and evaluated the correlation between D-dimer and CRP and ferritin. Results Median D-dimer, CRP, and ferritin concentrations were 2240 µg/L, 73.2 mg/L, and 1173.8 µg/mL, respectively. The highest median D-dimer value was seen in mild and moderate acute respiratory distress syndrome (ARDS). The highest ferritin concentration was seen in severe ARDS. There was a significant correlation between D-dimer value and CRP (r = 0.327), but no significant correlation between D-dimer and ferritin (r = 0.101). The area under the receiver operating characteristic curve (AUC) for the combination of CRP ≥72.65 mg/L and D-dimer ≥1250 µg/L as a marker of COVID-19 severity was 0.722 (95% confidence interval (CI): 0.615–0.781). Conclusion The combination of CRP ≥72.65 mg/L and D-dimer ≥1250 µg/L can be used as marker of COVID-19 severity, with moderate accuracy.

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“…High levels of ferritin are indicative of hemolysis and are implicated in the COVID-19 severity since the patient's admission ( 72 , 73 ). These ferritin changes were reported ( 57 ) as mediators of immune dysregulation, contributing to the cytokine storm ( 24 ).…”

Section: Clinical Exam and Proteomics: Perspectivesmentioning

confidence: 99%

Dysregulation in erythrocyte dynamics caused by SARS-CoV-2 infection: possible role in shuffling the homeostatic puzzle during COVID-19

Mendonça

Cruz

Pinheiro

et al. 2022

Hematology, Transfusion and Cell Therapy

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Introduction : The evolving COVID-19 pandemic became a hallmark in human history, not only by changing lifestyles, but also by enriching scientific knowledge on viral infection and its consequences. Objective : Although management of cardiorespiratory changes is pivotal to a favorable prognosis during severe clinical findings, dysregulation of other systems caused by SARS-CoV-2 infection may imbalance erythrocyte dynamics, such as a bidirectional positive feedback loop pathophysiology. Method and Results : Recent evidence shows that SARS-CoV-2 is capable of affecting the genetics and dynamics of erythrocytes and this coexists with a non-homeostatic function of cardiovascular, respiratory and renal systems during COVID-19. In hypothesis, SARS-CoV-2-induced systematical alterations of erythrocytes dynamics would constitute a setpoint for COVID-19-related multiple organ failure syndrome and death. Conclusion : The present review covers the most frequent erythrocyte-related non-homeostatic findings during COVID-19 capable of providing mechanistic clues of SARS-CoV-2-induced infection and inspiring therapeutic-oriented scientific evidence.

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Serum ferritin at admission in hospitalized COVID-19 patients as a predictor of mortality

Cited by 56 publications

References 19 publications

Acute Kidney Disease and Mortality in Acute Kidney Injury Patients with COVID-19

Acute Kidney Disease and Mortality in Acute Kidney Injury Patients with COVID-19

Coagulation profile and correlation between D-dimer, inflammatory markers, and COVID-19 severity in an Indonesian national referral hospital

Dysregulation in erythrocyte dynamics caused by SARS-CoV-2 infection: possible role in shuffling the homeostatic puzzle during COVID-19

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