Attenuated initial serum ferritin concentration in critically ill coronavirus disease 2019 geriatric patients with comorbid psychiatric conditions

• Published in: Frontiers in psychiatry Vol. 13; p. 1035986
• Main Authors: Abulseoud, Osama A, Yehia, Asmaa, Egol, Claudine J, Nettey, Victor N, Aly, Mohamed, Qu, Yihuai, Skolnik, Aaron B, Grill, Marie F, Sen, Ayan, Schneekloth, Terry D
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 09.11.2022
• Subjects: COVID-19; critical illness mortality; delirium; ferritin; geriatric; psychiatric disorders; Psychiatry; COVID-19; critical illness mortality; ferritin; geriatric; delirium; psychiatric disorders
• ISSN: 1664-0640; 1664-0640
• DOI: 10.3389/fpsyt.2022.1035986

We examined the effects of psychiatric comorbidity, sex, and ICU admission on serum ferritin concentration in 628 elderly patients (79.7 ± 8.5 years) with positive SARS-CoV-2 PCR test. Hospitalization was required in 96% of patients and 17% required ICU admission. Patients with COVID-19 and psychiatric comorbidities ( = 212) compared to patients without psychiatric comorbidities ( = 416) had significantly lower ferritin concentration (570.4 ± 900.1 vs. 744.1 ± 965, = 0.029), a greater incidence of delirium (22.6 vs. 14.4%, = 0.013) and higher mortality (35.3 vs. 27.6%, = 0.015). Furthermore, we found significant effects for sex ( = 0.002) and ICU admission ( = 0.007). Among patients without comorbid psychiatric conditions, males had significantly higher ferritin compared to females (1,098.3 ± 78.4 vs. 651.5 ± 94.4, < 0.001). ICU patients without comorbid psychiatric conditions had significantly higher serum ferritin compared to ICU patients with comorbid psychiatric conditions: (1,126.6 ± 110.7 vs. 668.6 ± 156.5, < 0.001). Our results suggest that the presence of comorbid psychiatric conditions in elderly patients with COVID-19 is associated with higher rates of delirium and mortality and lower ferritin levels during severe illness. Whether high serum ferritin is protective during severe infection requires further investigation.