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Hyperferritinemia as a factor associated with poor prognosis in COVID-19 patients
Insights
High ferritin, C-reactive protein, and D-dimer levels predict severe COVID-19 outcomes in Arab populations. These biomarkers indicate a higher risk of poor prognosis for individuals with severe coronavirus disease.
Area of Science:
- Infectious Diseases
- Clinical Biochemistry
- Hematology
Background:
- COVID-19 has caused widespread infection globally, with a subset of patients developing severe symptoms.
- Understanding clinical and laboratory predictors of COVID-19 severity is crucial for patient management and prognosis.
Purpose of the Study:
- To investigate the association between clinical and laboratory parameters and the severity of COVID-19 in an Arab cohort.
- To identify reliable biomarkers for predicting severe disease and poor outcomes in COVID-19 patients.
Main Methods:
- A prospective cohort study involving 466 Arab participants, including 169 COVID-19 cases and 297 controls.
- Clinical data and laboratory markers such as ferritin, C-reactive protein (CRP), D-dimer, white blood cell count (WBC), IgM, granulocytes, and lymphocytes were analyzed.
- Statistical comparisons were made between mild and severe COVID-19 cases and controls.
Main Results:
- Severe COVID-19 was significantly associated with elevated levels of ferritin, CRP, D-dimer, WBC, IgM, and granulocytes compared to controls.
- A significant decrease in lymphocyte count was observed in patients with severe COVID-19.
- COVID-19 patients with severe symptoms exhibited a four-fold increase in serum ferritin levels upon admission, correlating with high CRP and D-dimer.
Conclusions:
- Hyperferritinemia, elevated CRP, and D-dimer are reliable predictors of COVID-19 severity and poor prognosis in the Arab population.
- These biomarkers can aid in early identification of high-risk patients requiring intensive monitoring and management.
- Further research can explore the therapeutic implications of targeting these markers in severe COVID-19.
Abstract:
Worldwide, hundreds of millions of people have been infected with COVID-19 since December 2019; however, about 20% or less developed severe symptoms. The main aim of the current study was to assess the relationship between the severity of Covid-19 and different clinical and laboratory parameters. A total number of 466 Arabs have willingly joined this prospective cohort. Out of the total number, 297 subjects (63.7%) had negative COVID-19 tests, and thus, they were recruited as controls, while 169 subjects (36.3%) who tested positive for COVID-19 were enrolled as cases. Out of the total number of COVID-19 patients, 127 (75.15%) presented with mild symptoms, and 42 (24.85%) had severe symptoms. The age range for the participants was 20 to 82 years. Compared with controls, the severity of the disease was associated with significantly high ferritin levels (P < 0.001). The severity of the disease was also associated with a significant increase in C-reactive protein (P < 0.001), D-dimer (P < 0.001), white blood cell count (WBC) (P < 0.01), IgM (P < 0.001), and Granulocytes (P < 0.01). In addition, severe COVID-19 symptoms in the current study were associated with a significant decrease in lymphocytes (P < 0.01). There was a four-fold increase in serum ferritin levels in COVID-19 patients presented with severe symptoms upon admission. The former was associated with significantly high levels of CRP and D-dimer. Thus, hyperferritinemia, together with high CRP and D-dimer concentrations, may serve as reliable predictors for disease severity and poor prognosis in Arabs with COVID-19.
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