Elevated serum ferritin level in inpatients

Abstract

Serum ferritin is considered one of the predictors of severe forms of diseases and an increased mortality risk in patients with various diseases. However, the results of the studies performed to date are not heterogeneous and the usefulness of measuring serum ferritin in all inpatients, including those with COVID‑19, is being questioned. The study included the results of measuring serum ferritin in 761 adult patients, of which in the main group 634 were confirmed with COVID‑19, and 127 patients from the comparison group were hospitalized with other diagnoses. Differences in serum ferritin concentration in the main group (COVID‑19 “+”: survivors: Me 295.2, 95% CI: 353.8–449.1 µg/l, non-survivors Me 285.9, 95% CI: 309.9–628.9 µg/l) and in the comparison group (COVID‑19 “-”: survivors Me 267.2: 95% CI 268.2–526.0 µg/l, non-survivors Me 197.7, 95% CI: 110.3–529.0 µg/l) depending on the outcomes of the disease were not statistically significant. At the same time, in the cohort of the non-survivors, serum ferritin above 500 µg/l with COVID‑19 was 23.75 times more common, and in the cohort with a ferritin concentration above 1500 µg/l, 17.75 times more common than ferritin in the group of inpatients without COVID–19. Our results indicate the impracticality of measuring serum ferritin for all inpatients; however, they confirm the fact that selective measurement of serum ferritin in patients with severe course of diseases, especially infectious diseases, makes it possible to identify a category of patients with a high risk of developing hyperinflammation.