Multiuser Laboratory for Research Support in Nephrology and Medical Sciences (LAMAP), Faculty of Medicine, Universidade Federal Fluminense, Niteroi, RJ, Brazil; Pediatric Rheumatology Unit, Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Niteroi, RJ, Brazil.
Multiuser Laboratory for Research Support in Nephrology and Medical Sciences (LAMAP), Faculty of Medicine, Universidade Federal Fluminense, Niteroi, RJ, Brazil.
Braz J Infect Dis. 2021 Mar-Apr;25(2):101569. doi: 10.1016/j.bjid.2021.101569. Epub 2021 Mar 15.
Some COVID-19 patients have higher mortality and the responsible factors for this unfavorable outcome is still not well understood.
To study the association between ferritin levels at admission, representing an inflammatory state, and hospital mortality in COVID-19 patients.
From May through July 2020, SARS-CoV-2 positive patients with moderate to severe clinical symptoms were evaluated at admission, regarding clinical and laboratory data on renal and hepatic function, hematologic parameters, cytomegalovirus co-infection, and acute phase proteins.
A total of 97 patients were included; mean age=59.9±16.3 years, 58.8% male, 57.7% non-white, in-hospital mortality=45.4%. Age, ferritin, C-reactive protein, serum albumin and creatinine were significantly associated with mortality. Ferritin showed area under the curve (AUC) of 0.79 (p<0.001) for the cut-off of 1873.0ng/mL, sensitivity of 68.4% and specificity of 79.3% in predicting in-hospital mortality. Age ≥60 years had an odds ratio (OR) of 10.5 (95% CI=1.8-59.5; p=0.008) and ferritin ≥1873.0ng/mL had an OR of 6.0 (95% CI=1.4-26.2; p=0.016), both independently associated with mortality based on logistic regression analysis.
The magnitude of inflammation present at admission of COVID-19 patients, represented by high ferritin levels, is independently predictive of in-hospital mortality.
一些 COVID-19 患者的死亡率较高，导致这种不良预后的因素仍未得到很好的理解。
研究入院时铁蛋白水平（代表炎症状态）与 COVID-19 患者住院死亡率之间的关系。
2020 年 5 月至 7 月，对有中度至重度临床症状的 SARS-CoV-2 阳性患者进行评估，评估内容包括肾功能和肝功能、血液学参数、巨细胞病毒合并感染和急性期蛋白的临床和实验室数据。
共纳入 97 例患者，平均年龄为 59.9±16.3 岁，58.8%为男性，57.7%为非白人，住院死亡率为 45.4%。年龄、铁蛋白、C 反应蛋白、血清白蛋白和肌酐与死亡率显著相关。铁蛋白的截断值为 1873.0ng/mL 时，其预测住院死亡率的曲线下面积（AUC）为 0.79（p<0.001），灵敏度为 68.4%，特异性为 79.3%。年龄≥60 岁的比值比（OR）为 10.5（95%可信区间为 1.8-59.5；p=0.008），铁蛋白≥1873.0ng/mL 的 OR 为 6.0（95%可信区间为 1.4-26.2；p=0.016），两者均基于逻辑回归分析独立与死亡率相关。
COVID-19 患者入院时炎症程度（由铁蛋白水平升高表示）与住院死亡率独立相关。
