Deng Fuxue, Zhang Lisha, Lyu Lyu, Lu Ziwei, Gao Dengfeng, Ma Xiaorong, Guo Yonghong, Wang Rong, Gong Shouping, Jiang Wei
Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, China.
Department of Hematology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, China.
Med Clin (Engl Ed). 2021 Apr 9;156(7):324-331. doi: 10.1016/j.medcle.2020.11.015. Epub 2021 Apr 1.
The aim of this study was to evaluate hyperferritinemia could be a predicting factor of mortality in hospitalized patients with coronavirus disease-2019 (COVID-19).
A total of 100 hospitalized patients with COVID-19 in intensive care unit (ICU) were enrolled and classified into moderate ( = 17), severe ( = 40) and critical groups ( = 43). Clinical information and laboratory results were collected and the concentrations of ferritin were compared among different groups. The association between ferritin and mortality was evaluated by logistic regression analysis. Moreover, the efficiency of the predicting value was assessed using receiver operating characteristic (ROC) curve.
The amount of ferritin was significantly higher in critical group compared with moderate and severe groups. The median of ferritin concentration was about three times higher in death group than survival group (1722.25 μg/L vs. 501.90 μg/L, < 0.01). The concentration of ferritin was positively correlated with other inflammatory cytokines, such as interleukin (IL)-8, IL-10, C-reactive protein (CRP) and tumor necrosis factor (TNF)-α. Logistic regression analysis demonstrated that ferritin was an independent predictor of in-hospital mortality. Especially, high-ferritin group was associated with higher incidence of mortality, with adjusted odds ratio of 104.97 [95% confidence interval (CI) 2.63-4185.89; = 0.013]. Moreover, ferritin had an advantage of discriminative capacity with the area under ROC (AUC) of 0.822 (95% CI 0.737-0.907) higher than procalcitonin and CRP.
The ferritin measured at admission may serve as an independent factor for predicting in-hospital mortality in patients with COVID-19 in ICU.
本研究旨在评估高铁蛋白血症是否可能是2019冠状病毒病（COVID-19）住院患者死亡率的预测因素。
共纳入100例入住重症监护病房（ICU）的COVID-19住院患者，并分为中度组（n = 17）、重度组（n = 40）和危重组（n = 43）。收集临床信息和实验室结果，并比较不同组间铁蛋白浓度。通过逻辑回归分析评估铁蛋白与死亡率之间的关联。此外，使用受试者工作特征（ROC）曲线评估预测值的效能。
危重组铁蛋白水平显著高于中度组和重度组。死亡组铁蛋白浓度中位数约为存活组的三倍（1722.25μg/L对501.90μg/L，P < 0.01）。铁蛋白浓度与其他炎症细胞因子如白细胞介素（IL）-8、IL-10、C反应蛋白（CRP）和肿瘤坏死因子（TNF）-α呈正相关。逻辑回归分析表明，铁蛋白是院内死亡率的独立预测因素。特别是，高铁蛋白组死亡率发生率更高，校正比值比为104.97[95%置信区间（CI）2.63 - 4185.89；P = 0.013]。此外，铁蛋白具有鉴别能力优势，ROC曲线下面积（AUC）为0.822（95%CI 0.737 - 0.907），高于降钙素原和CRP。
入院时检测的铁蛋白可作为ICU中COVID-19患者院内死亡率的独立预测因素。
