Ferritin as a biomarker in inpatients with suspected COVID-19

• Published in: Revista de la Facultad de Medicina, Universidad Nacional de Colombia Vol. 71; no. 1; pp. e97180 - 36
• Main Authors: John Jaime Sprockel-Díaz, Chaves, Walter Gabriel, Diaztagle-Fernández, Juan José, Luis Oswaldo Martínez, Araque, Edna Carolina
• Format: Journal Article
• Language: English
• Published: Bogota Universidad Nacional de Colombia 2023
• Subjects: Biomarcadores; Biomarkers; COVID; COVID-19; Diagnosis; Diagnóstico; Ferritinas; Ferritins; Multivariate analysis; Prognosis; Pronóstico; Colombia
• ISSN: 0120-0011; 2357-3848; 2357-3848
• DOI: 10.15446/revfacmed.v71n1.97180

Introduction:Due to the clinical heterogeneity of COVID-19, biomarkers must be used to confirm the disease's diagnosis and determine its prognosis. Objective:To assess the performance of ferritin as a diagnostic biomarker in cases of suspected diagnosis of COVID-19 in inpatients and as a prognostic biomarker in those with a confirmed diagnosis. Materials and methods:Multicenter, prospective, observational study conducted in 711 adult patients hospitalized between April and November 2020 in three quaternary care hospitals in Bogotá D.C., Colombia, due to suspected COVID-19. Based on ferritin levels on hospital admission, ROC curves were created for three outcomes: diagnosis, admission to the intensive care unit (ICU), and death. The operating characteristics of this biomarker were calculated for each outcome, and a multivariate analysis was carried out using a linear regression model to evaluate the association between ferritin levels and each outcome. Results:COVID-19 diagnosis was confirmed in 592 patients, of whom 160 (27.02%) were admitted to the ICU and 107 (18.07%) died. The areas under the ROC curve (AUC) for diagnosis, ICU admission, and death were 0.67 (95%CI: 0.62-0.73), 0.58 (95%CI: 0.57-0.67), and 0.56 (95%CI: 0.50-0.63), respectively. In the bivariate analysis, ferritin levels were significantly associated with diagnosis (p=0.003) and admission to the ICU (p<0.001), but not with mortality (p=0.326). In the multivariate analysis, ferritin was only significantly associated with admission to the ICU (p=0.009). Conclusions:Ferritin showed poor and moderate performance as a prognostic and a diagnostic biomarker, respectively. Therefore, neither the diagnosis of patients with suspected COVID-19, nor the prognosis of those with a confirmed diagnosis can be determined based only on serum ferritin levels.