Elevated serum ferritin level effectively discriminates severity illness and liver injury of coronavirus disease 2019 pneumonia

Biomarkers. 2021 May;26(3):207-212. doi: 10.1080/1354750X.2020.1861098. Epub 2021 Feb 10.

Abstract

Aim: Ferritin is a hepatic protein that plays vital roles in diagnosing and predicting diseases, but its potential in coronavirus disease 2019 (COVID-19) remains unknown.

Method: We collected clinical records from 79 COVID-19 patients at Wuhan Union hospital (China). Spearman's correlation analysis, receiver operating characteristic (ROC) curve and Kaplan-Meier survival curves were employed.

Results: Patients with elevated ferritin levels had a higher incidence of severity illness (50.0 vs 2.9%) and liver injury (52.3 vs 20.0%) when compared with patients with normal ferritin levels (p < 0.05). Ferritin could effectively identify the severity of illness (ROC area 0.873) and liver injury (ROC area 0.752). The elevated ferritin group showed longer viral clearance time (median 16 vs 6 days, p < 0.001) and in-hospital length (median 18 vs 10 days, p < 0.001).

Conclusions: It suggests that ferritin could act as an easy-to-use tool to identify liver injury and severity illness and predict the prognosis of COVID-19 patients. Intensive surveillance is necessary for patients with abnormal ferritin levels.

Keywords: COVID-19; Ferritin; coronavirus; liver injury; risk factor.

MeSH terms

  • Adult
  • Biomarkers / blood
  • COVID-19 / blood
  • COVID-19 / epidemiology
  • COVID-19 / pathology*
  • COVID-19 / virology
  • China / epidemiology
  • Female
  • Ferritins / blood
  • Humans
  • Liver / pathology*
  • Liver / physiopathology
  • Liver Function Tests
  • Male
  • Middle Aged
  • SARS-CoV-2 / isolation & purification
  • Severity of Illness Index

Substances

  • Biomarkers
  • Ferritins

Grants and funding

This study was supported by the National Key R&D Program of China [2017YFC0909900] and National Natural Science Foundation of China [81903901].