Serum Ferritin Level in Categorization of COVID-19 Patients

Abstract

The current ongoing pandemic COVID-19 is characterized as highly contagious and deadly; early recognition of severe forms is absolutely essential for timely triaging of patients. While the clinical status, in particular peripheral oxygen saturation (SpO2) levels, and concurrent co-morbidities of COVID-19 patients largely determine the need for their admittance to ICUs, laboratory parameters may facilitate the assessment of disease severity . Hence the purpose of the present study is to estimate serum ferritin levels in covid-19 patients and analyze whether this inflammatory marker levels will be able to determine the severity and treatment protocol of COVID-19 patients. The study is a prospective observational study done in chettinad hospital & research institute. The study comprises of 100 patients diagnosed as covid -19 by qRT-PCR for SARS-CoV-2 and who were above 18 years. Pregnant or breast-feeding women, Patients with  rheumatoid immunity, malignant tumor and other related diseases, long-term oral immunoregulatory drugs or who had used large doses of glucocorticoids within 14 days were excluded from the study. The study population was divided into two groups mild to moderate – Group I and severe to critical- Group II, depending on the following criterias like age, fever, respiratory rate, oxygen saturationand  lymphocyte count. Serum ferritin levels  were measured in both the groups using chemiluminesnce assay by unicelDxi -600 access immunoassay systems- Beckman coulter and analyzed. Results: The mean ferritin value for the Group –I was 190ng/ml and   Group II was 833ng/ml. COVID-19 patients  especially with extremely high ferritin levels exhibited frequent symptomatic presentations, severity, and critical illness, in  group II  (P < 0.000)  and even in the group I, although the serum ferritin levels were  within the biological reference range ,there was  a statistically significant p –value  (P < 0.000)