Is Hyperferritinemia Reliable in Determining the Severity of COVID-19 in Older Patients?

Abstract

Aim: To determine whether ferritin levels among elderly patients inflicted with Covid-19 are superior to several types of disease severity indicators. Methods: A retrospective and cross-sectional analysis was conducted on patients who were admitted to the emergency department of Ordu University Training and Research Hospital between September 2020 and January 2021, with a suspected or confirmed diagnosis of Covid-19. Patients had to be 18 years of age or older and have a glomerular filtration rate greater than 30 ml/min/1.73 m2 in order to meet the basic inclusion criteria. In addition, the data pertaining to the patients’ chronic diseases, mortality status, hemogram, blood gas, ferritin, c-reactive protein, and vital signs were recorded alongside the information regarding the tests and examinations conducted for the diagnosis of Covid-19. The data set is divided into two parts: <65 years ≥65 years. Results: Four hundred sixteen patients were identified as meeting the criteria for the study. Out of the total number of patients, 321 were under the age of 65, while 95 were 65 years of age or older. The under-65 group’s mean age was 42.50±12.73 while the older group was 77.89±7.34 years. The mean ferritin of patients 65 and older (249.59±261.45 ng/mL) was significantly more than the patients under 65 (169.76±210.44 ng/mL) (p=0.001). Only mortality differed between older and younger patients (p=0.049). The AUC value of ferritin in older patients was 0.700 (95% CI, 0.482-0.919), and the cut-off value was 231.55 ng/mL in the mortal group (sensitivity=66.7%, specificity=67.4%). Only ferritin levels were significant in older patients’ AUC scores of mortality stats among the other biomedical markers. Conclusions: Some well-known severe disease blood markers, including c-reactive protein, are not as significant as ferritin in older patient mortality ROC curve analyses. Ferritin may be the strongest mortality predictor in older Covid-19 patients.