Journal
BRAZILIAN JOURNAL OF INFECTIOUS DISEASES
Volume 25, Issue 2, Pages -Publisher
ELSEVIER BRAZIL
DOI: 10.1016/j.bjid.2021.101569
Keywords
SARS-CoV-2; Ferritin; Mortality; Cytokine storm; Hemophagocytic; lymphohistiocytosis
Categories
Funding
- Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES) [001]
- Conselho Nacional de desenvolvimento Cientifico e Tecnologico (CNPq)
- Ministerio da Educacao (UFF)
- Brazilian Innovation Agency (FINEP) through Ministerio daCiencia, Tecnologia e Inovacoesn REDE VIRUS/Laboratorios de Campanha
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This study found a significant association between ferritin levels at admission and in-hospital mortality in COVID-19 patients, with high ferritin levels independently predicting mortality.
Introduction: Some COVID-19 patients have higher mortality and the responsible factors for this unfavorable outcome is still not well understood. Objective: To study the association between ferritin levels at admission, representing an inflammatory state, and hospital mortality in COVID-19 patients. Methods: From May through July 2020, SARS-CoV-2 positive patients with moderate to severe clinical symptoms were evaluated at admission, regarding clinical and laboratory data on renal and hepatic function, hematologic parameters, cytomegalovirus co-infection, and acute phase proteins. Results: A total of 97 patients were included; mean age = 59.9 +/- 16.3 years, 58.8% male, 57.7% non-white, in-hospital mortality = 45.4%. Age, ferritin, C-reactive protein, serum albumin and creatinine were significantly associated with mortality. Ferritin showed area under the curve (AUC) of 0.79 (p <0.001) for the cut-off of 1873.0 ng/mL, sensitivity of 68.4% and specificity of 79.3% in predicting in-hospital mortality. Age >= 60 years had an odds ratio (OR) of 10.5 (95% CI= 1.8-59.5; p = 0.008) and ferritin >= 1873.0 ng/mL had an OR of 6.0 (95% CI= 1.4-26.2; p = 0.016), both independently associated with mortality based on logistic regression analysis. Conclusion: The magnitude of inflammation present at admission of COVID-19 patients, represented by high ferritin levels, is independently predictive of in-hospital mortality. (C) 2021 Sociedade Brasileira de Infectologia. Published by Elsevier Espana, S.L.U.
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