Association of Ferritin Levels and Biochemical Markers with COVID-19 Severity

Abstract

Objective: To investigate the association between ferritin levels and other biochemical markers (such as total bilirubin, LDH, AST, and ALT) with the severity of COVID-19 and to identify potential predictive markers that could help in assessing disease severity, improving patient management, and reducing mortality rates.

Methodology: This retrospective observational study was conducted between June 2020 to December 2020 admitted to various hospitals in twin cities, comprised 420 confirmed cases of COVID-19 detected through PCR testing. Blood samples collected upon admission from patients in various hospitals across Islamabad and Rawalpindi were analyzed for Lactate Dehydrogenase (LDH), Aspartate Aminotransferase (AST), Alanine Transaminase (ALT), Total Bilirubin and ferritin levels . The diagnosis was made using Reverse Transcription-Polymerase Chain Reaction (RT-PCR) on nasal and pharyngeal swab specimens

The data was statistically analyzed by using SPSS ver 25. The Kruskal-Wallace test was used to compare severe, moderate, and mild patient COVID-19 groups

Results: The mean age of the deceased was significantly high 76.09±?4.94 years  vs 54.34?±?13.03 years compared to those recovered.  Deceased had ten times higher median levels of ferritin 1000 ng/ml vs. 120ng/ml. In multivariate analysis, advanced age (AOR 1.673 C.I (1.372,2.040) p = 0.0001)and a raised level of ferritin (AOR 2.938 C.I. (1.244,6.941) p = 0.014)   showed significant association with mortality.

Conclusion: Ferritin and age can be used to predict the severity of COVID-19. This study can help physicians to lower the mortality rate and number of admissions in the ICU.