铁蛋白与铁比值升高对新型冠状病毒肺炎患者院内预后的不利影响。
The detrimental impact of elevated Ferritin to Iron ratio on in-hospital prognosis of patients with COVID-19.
作者信息
Bianconi Vanessa, Mannarino Massimo R, Figorilli Filippo, Cosentini Elena, Batori Giuseppe, Marini Ettore, Banach Maciej, Sahebkar Amirhossein, Pirro Matteo
机构信息
Unit of Internal Medicine, Department of Medicine and Surgery, University of Perugia, Perugia, Italy.
Department of Hypertension, Wam University Hospital, Medical University of Lodz, Lodz, Poland.
出版信息
Expert Rev Mol Diagn. 2022 Apr;22(4):469-478. doi: 10.1080/14737159.2022.2052047. Epub 2022 Mar 15.
BACKGROUND
Acute viral infections, including coronavirus disease 2019 (COVID-19), are characterized by the dysregulation of iron metabolism, resulting in high serum ferritin and low iron levels.
RESEARCH DESIGN AND METHODS
This study aimed to evaluate the prospective impact of iron metabolism dysregulation, as expressed by serum Ferritin-to-Iron Ratio (FIR), on the in-hospital prognosis of patients with COVID-19. Serum levels of ferritin and iron, as well as other iron metabolism markers and recognized prognostic indicators of COVID-19 severity, were measured in 362 patients consecutively hospitalized for COVID-19. The prospective relationship between FIR and the risk of the composite outcome of intensive care unit (ICU) admission/in-hospital death was analyzed.
RESULTS
In the population examined (mean age 74 ± 15 years, males 55%), the rates of radiographic signs of pneumonia, respiratory distress, and the need for noninvasive ventilation were higher in patients with high FIR (≥29.2, the 75 percentile) than in those with low FIR (<29.2, the 75 percentile) (p < 0.05 for all comparisons). High FIR was associated with a 1.7-fold (HR 1.709, 95% CI 1.017-2.871, p = 0.043) higher risk of ICU admission/in-hospital death.
CONCLUSIONS
Increasing FIR values significantly and independently predicts worse in-hospital prognosis in hospitalized patients with COVID-19.
背景
包括2019冠状病毒病（COVID-19）在内的急性病毒感染的特征是铁代谢失调，导致血清铁蛋白升高和铁水平降低。
研究设计与方法
本研究旨在评估以血清铁蛋白与铁比值（FIR）表示的铁代谢失调对COVID-19患者住院预后的前瞻性影响。对362例因COVID-19连续住院的患者测定了铁蛋白和铁的血清水平，以及其他铁代谢标志物和公认的COVID-19严重程度预后指标。分析了FIR与重症监护病房（ICU）入院/院内死亡复合结局风险之间的前瞻性关系。
结果
在所研究的人群（平均年龄74±15岁，男性占55%）中，FIR高（≥29.2，第75百分位数）的患者肺炎的影像学征象、呼吸窘迫以及无创通气需求的发生率高于FIR低（<29.2，第75百分位数）的患者（所有比较p<0.05）。高FIR与ICU入院/院内死亡风险高1.7倍（HR 1.709，95%CI 1.017-2.871，p=0.043）相关。
结论
FIR值升高显著且独立地预测COVID-19住院患者更差的住院预后。
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