Tanwar Shashi, Mishra Nibha, Sharma Prachi, Kaur Apjit
Department of Ophthalmology, King George Medical University, Lucknow, Uttar Pradesh, India.
Indian J Ophthalmol. 2025 Feb 1;73(2):223-227. doi: 10.4103/IJO.IJO_574_23. Epub 2024 Jul 11.
Effect of serum ferritin on severity of coronavirus disease 2019 (COVID-19)-associated rhino-orbito-cerebral mucormycosis.
To study the association between increased serum ferritin and severity of orbital disease in COVID-19-associated rhino-orbito-cerebral mucormycosis.
A cross-sectional study.
Hundred ( n ) out of 155 treatment-naive patients of COVID-19 infection presenting with the signs and symptoms of rhino-orbito-cerebral mucormycosis were enrolled in study. Based on the classification proposed by Honavar, the study patients were classified into four stages: Stage 1: involvement of the nasal mucosa ( n = 11), Stage 2: involvement of paranasal sinuses ( n = 14), Stage 3: involvement of the orbit ( n = 37), Stage 4: involvement of the central nervous system ( n = 38). Stage 3 was further divided into four substages: 3a: nasolacrimal duct, medial orbit, vision unaffected ( n = 4); 3b: diffuse orbital involvement (>1 quadrant or >2 structures), vision unaffected ( n = 15); 3c: central retinal artery occlusion or ophthalmic artery occlusion, superior ophthalmic vein thrombosis, involvement of superior orbital fissure, inferior orbital fissure, orbital apex, diminution or loss of vision ( n = 13); 3d: bilateral orbital involvement ( n = 5). Fasting blood sugar (FBS), postprandial blood sugar (PPBS), and inflammatory markers (serum ferritin, interleukin-6, C-reactive protein, and D-dimer) were assessed. Serum level of ferritin was analyzed by using chemiluminescence immunoassay method.
Mean FBS (mg/dl) was 165.03 ± 70.43 for stage 1, 185.67 ± 64.82 for stage 2, 159.05 ± 68.60 for stage 3, and 158.20 ± 62.05 for stage 4. Mean PPBS (mg/dl) was 238.70 ± 141.29 for stage 1, 252 ± 103.69 for stage 2, 257.09 ± 103.48 for stage 3, and 229.53 ± 76.81 for stage 4. Mean serum ferritin (μg/l) was 302.67 ± 266.95 in stage 1, 444.19 ± 116.36 in stage 2, 504.85 ± 205.99 in stage 3, and 825.95 ± 777.30 in stage 4. A statistically significant increase in serum ferritin levels with severity of disease ( P = 0.005) was noted. Similar trend was observed in substages of stage 3. Pearson correlation analysis showed a positive correlation between serum ferritin and severity of disease ( P = 0.0007).
Increased serum ferritin was significantly independently associated with severity of orbital disease in COVID-19-associated rhino-orbito-cerebral mucormycosis.
血清铁蛋白对2019冠状病毒病（COVID-19）相关鼻眶脑毛霉菌病严重程度的影响。
研究血清铁蛋白升高与COVID-19相关鼻眶脑毛霉菌病眼眶疾病严重程度之间的关联。
一项横断面研究。
155例初治的COVID-19感染患者出现鼻眶脑毛霉菌病的体征和症状，其中100例纳入研究。根据霍纳瓦尔提出的分类方法，将研究患者分为四个阶段：1期：鼻黏膜受累（n = 11）；2期：鼻窦受累（n = 14）；3期：眼眶受累（n = 37）；4期：中枢神经系统受累（n = 38）。3期进一步分为四个亚阶段：3a：鼻泪管、眼眶内侧，视力未受影响（n = 4）；3b：弥漫性眼眶受累（>1个象限或>2个结构），视力未受影响（n = 15）；3c：视网膜中央动脉闭塞或眼动脉闭塞、眼上静脉血栓形成、眶上裂、眶下裂、眶尖受累，视力减退或丧失（n = 13）；3d：双侧眼眶受累（n = 5）。评估空腹血糖（FBS）、餐后血糖（PPBS）和炎症标志物（血清铁蛋白、白细胞介素-6、C反应蛋白和D-二聚体）。采用化学发光免疫分析法分析血清铁蛋白水平。
1期的平均FBS（mg/dl）为165.03±70.43，2期为185.67±64.82，3期为159.05±68.60，4期为158.20±62.05。1期的平均PPBS（mg/dl）为238.70±141.29，2期为252±103.69，3期为257.09±103.48，4期为229.53±76.81。1期的平均血清铁蛋白（μg/l）为302.67±266.95，2期为444.19±116.36，3期为504.85±205.99，4期为825.95±777.30。发现血清铁蛋白水平随疾病严重程度有统计学显著升高（P = 0.005）。在3期亚阶段中观察到类似趋势。Pearson相关分析显示血清铁蛋白与疾病严重程度呈正相关（P = 0.0007）。
血清铁蛋白升高与COVID-19相关鼻眶脑毛霉菌病眼眶疾病严重程度显著独立相关。
