Spectral Medical Inc T.EDT

RE:RE:RE:Polymyxin B haemoperfusion treatment for respiratory failure

[EndoHypot]

Italy, Isreal and China.



In this Journal, Li and colleagues recently reported that Serum Amyloid A is a biomarker of severe Coronavirus Disease and poor prognosis¹. Evidence shows that severe COVID-19 cases exhibit features of systemic inflammatory reactions, including hyperferritinemia. We conducted a retrospective study included 147 confirmed COVID-19 patients in Changsha, a non-epicenter city of China. The overall proportion of severe disease was 16.32% (24/147). Table 1 shows the differences in the baseline characteristics between severe and nonsevere COVID-19 patients. The severe patients had higher levels of serum ferritin than the nonsevere patients (Fig. 1 A).

Wu et al. investigated 201 confirmed cases of COVID-19 to study the clinical characteristics and outcomes in patients with COVID-19 pneumonia who developed acute respiratory distress syndrome (ARDS) or died; their findings showed that higher serum ferritin was an independent risk factor associated with ARDS development.² Another meta-analysis also recommended serum ferritin as a candidate variable for risk stratification models that may serve as clinical predictors of severe and fatal COVID-19.³ In our study, when patients were grouped according to the serum ferritin level with a cut off of 500ng/ml derived from the HLH-2004 criterion, hyperferritinemia accounted for 29.93% (44/147) of patients. The hyperferritinemia group had a higher proportion of severe cases (31.82% vs. 9.71%, P=0.0009) and bilateral pulmonary infiltration rate (95.45% vs. 79.61%, P=0.0297) than patients without hyperferritinemia. Hyperferritinemic COVID-19 patients were older and more likely to be male. Moreover, these patients had significantly higher levels of serum creatine, ALT, AST and LDH, lower levels of lymphocytes, and significantly higher levels of inflammatory markers, such as CRP, PCT and d-dimer, than the patients in the nonhyperferritinemia group. All these indicators have been reported as warning parameters for severe or critical COVID-19 patients. In addition, these correlations may indicate that patients with hyperferritinemia tend to have more severe disease than those without hyperferritinemia. Multivariate logistic regression models were adjusted for several disease-related risk factors at admission, including age, neutrophil count, lymphocyte count, d-dimer, LDH, C-reactive protein, and procalcitonin, the analysis found that the serum ferritin level was an independent risk factor for disease severity in COVID-19 patients (OR=3.302, 95% CI, 1.141∼9.553, P=0.028). And ROC curve study confirmed the predictive value of serum ferritin (AUC=0.7480, P <0.001).

In conclusion, this retrospective study performed in a Chinese population demonstrated that a high level of serum ferritin is an independent risk factor for the severity of COVID-19. Assessing serum ferritin levels during hospitalization may be important to recognize high-risk individuals with COVID-19.


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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7313486/