Serum Ferritin is an independent risk factor for Acute Respiratory Distress Syndrome in COVID-19

Gandini, Orietta; Criniti, Anna; Ballesio, Laura; Giglio, Simona; Galardo, Gioacchino; Gianni, Walter; Santoro, Luigi; Angeloni, Antonio; Lubrano, Carla

doi:10.1016/j.jinf.2020.09.006

Cited by 64 publications

(59 citation statements)

References 9 publications

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“… 5 We, like many other authors, recently published that serum Ferritin is an independent risk factor for ARDS in COVID-19 patients. 6 , 7 , 8 Our study demonstrates that serum Ferritin is a good discriminator of the combined outcome of either death or ICU admission and that hyperferritinemia was observed in all patients with severe disease on admission. ROC curve analysis confirmed the excellent prognostic accuracies of serum Ferritin in discriminating patients with severe clinical conditions for concentrations above >644 µg/L with a sensitivity 88,33% and a specificity 93,83%; (AUC 0.939, CI: 0,894 to 0,985 p < 0.001) ( fig.…”

mentioning

confidence: 63%

Use of rapid ferritin test to predict clinical deterioration in at home COVID-19 patients

Gandini¹,

Lubrano

2021

Journal of Infection

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mentioning

confidence: 63%

Use of rapid ferritin test to predict clinical deterioration in at home COVID-19 patients

Gandini¹,

Lubrano

2021

Journal of Infection

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“…Cytokine storm syndrome can cause multiorgan failure and hyperferritinemia 137,151,231,232 . A study including 141 patients with COVID‐19 reported that hyperferritinemia (Serum ferritin > 500 μg/L) was observed in all severe patients on admission, and the mild cases had a normal mean serum ferritin level of (303 ± 224 μg/ml); moreover, severe and ICU patients had higher ferritin levels than the mild patients (2.6 times and 5.8 times, respectively) 233 . Another study found higher mean serum ferritin levels in moderate and severe patients than in mild patients (mild 327.27; moderate 1555; severe 2817.6; ng/ml) 234 .…”

Section: Laboratory Indicatorsmentioning

confidence: 99%

Risk factors for severe and critically ill COVID‐19 patients: A review

Gao

Ding

Dong

et al. 2020

Allergy

1,161

864

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The pandemic of coronavirus disease 2019 (COVID‐19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), has caused an unprecedented global social and economic impact, and high numbers of deaths. Many risk factors have been identified in the progression of COVID‐19 into a severe and critical stage, including old age, male gender, underlying comorbidities such as hypertension, diabetes, obesity, chronic lung diseases, heart, liver and kidney diseases, tumors, clinically apparent immunodeficiencies, local immunodeficiencies, such as early type I interferon secretion capacity, and pregnancy. Possible complications include acute kidney injury, coagulation disorders, thoromboembolism. The development of lymphopenia and eosinopenia are laboratory indicators of COVID‐19. Laboratory parameters to monitor disease progression include lactate dehydrogenase, procalcitonin, high‐sensitivity C‐reactive protein, proinflammatory cytokines such as interleukin (IL)‐6, IL‐1β, Krebs von den Lungen‐6 (KL‐6), and ferritin. The development of a cytokine storm and extensive chest computed tomography imaging patterns are indicators of a severe disease. In addition, socioeconomic status, diet, lifestyle, geographical differences, ethnicity, exposed viral load, day of initiation of treatment, and quality of health care have been reported to influence individual outcomes. In this review, we highlight the scientific evidence on the risk factors of severity of COVID‐19.

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“…A key feature of patients who progress from Stage I COVID-19 disease to increasingly severe Stage II and Stage III disease is blood biomarker evidence of the maladaptive DAMP-mediated loss of innate immunity regulation with excessive levels of circulating proinflammatory cytokines and chemokines (IL-6, IL-2, IL-7, IL-10, G-CSF, CXCL-10, MCP1, IFNγ, MIP1α, TNFα). 5 Traditional biomarkers of acute systemic inflammation include C-reactive protein (CRP) and ferritin which positively correlate with severity of COVID-19 disease, 52 , 53 but are of limited utility as they lack specificity and do not inform therapeutic decisions. In addition to dysregulated cytokine release, excessive secretion of proteases and generation of reactive oxygen species (ROS) by infiltrating immune cells contribute to the hyperinflammation characteristic of severe COVID-19 disease ( Figure 2 ).…”

Section: Anti-inflammatory Therapeutic Strategies In Covid-19mentioning

confidence: 99%

Strategies to DAMPen COVID-19-mediated lung and systemic inflammation and vascular injury

Bime

Casanova

Nikolich‐Žugich

et al. 2021

Translational Research

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Approximately 15%-20% of patients infected with SARS-CoV-2 coronavirus (COVID-19) progress beyond mild and self-limited disease to require supplemental oxygen for severe pneumonia; 5% of COVID-19-infected patients further develop acute respiratory distress syndrome (ARDS) and multi-organ failure. Despite mortality rates surpassing 40%, key insights into COVID-19-induced ARDS pathology have not been fully elucidated and multiple unmet needs remain. This review focuses on the unmet need for effective therapies that target unchecked innate immunity-driven inflammation which drives unchecked vascular permeability, multi-organ dysfunction and ARDS mortality. Additional unmet needs including the lack of insights into factors predicting pathogenic hyperinflammatory viral host responses, limited approaches to address the vast disease heterogeneity in ARDS, and the absence of clinically-useful ARDS biomarkers. We review unmet needs persisting in COVID-19-induced ARDS in the context of the potential role for damage-associated molecular pattern proteins in lung and systemic hyperinflammatory host responses to SARS-CoV-2 infection that ultimately drive multiorgan dysfunction and ARDS mortality. Insights into promising stratification-enhancing, biomarker-based strategies in COVID-19 and non-COVID ARDS may enable the design of successful clinical trials of promising therapies.

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Serum Ferritin is an independent risk factor for Acute Respiratory Distress Syndrome in COVID-19

Cited by 64 publications

References 9 publications

Use of rapid ferritin test to predict clinical deterioration in at home COVID-19 patients

Use of rapid ferritin test to predict clinical deterioration in at home COVID-19 patients

Risk factors for severe and critically ill COVID‐19 patients: A review

Strategies to DAMPen COVID-19-mediated lung and systemic inflammation and vascular injury

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