| Autor: |
Nishant, Raman, Padmaprakash, Kv, Kuldeep Kumar, Ashta, Vasu, Vardhan, Sandeep, Thareja, Muthukrishnan, J, Abhinav, Kumar, Basavaraj |
| Rok vydání: |
2021 |
| Předmět: |
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| Zdroj: |
The Journal of the Association of Physicians of India. 69(8) |
| ISSN: |
0004-5772 |
| Popis: |
Infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have multisystemic involvement with hyperinflammation being a cardinal feature and deranged iron metabolism having a possible role. In this premise, we studied the prognostic value of two markers of iron metabolism ferritin and hemoglobin.A retrospective-cohort study was carried out in a tertiary hospital in northern India involving 210 hospitalized COVID-19 patients aged 15-and above. Analysis was done for clinical profile, comorbidities and basic laboratory indices including ferritin-hemoglobin ratio (FHR) with primary end-point being in-hospital all-cause mortality.Median serum ferritin levels (640.00ng/mL vs 220.00ng/mL) were significantly higher among non-survivors as against survivors while median hemoglobin levels were significantly lower (12.12g/dL vs 13.73g/dL). Serum ferritin levelsgt;400ng/mL (Sn 80%, Sp 70%) predicted mortality with high sensitivity and specificity. Notably, serum ferritin levelsgt;400ng/mL (HR 11.075 [1.481-82.801]) and anemia, defined as a hemoglobin oflt;12g/dL for females andlt; 13g/dL for males and were significantly associated with the risk of mortality in a univariable Cox-proportional hazards regression. The median FHR was significantly higher among non-survivors compared to survivors (56.98 vs 17.17). FHRgt;31 (Sn 85% Sp 71.6%) was highly sensitive and specific for predicting mortality. The multivariable analysis indicated that FHRgt;31 remained an independent risk factor for mortality (HR 12.293 [3.147-48.028]).Ferritin-hemoglobin ratio (FHR), which encompasses into a single index, the effects of both elevated levels of ferritin and the severity of anemia, seems to perform particularly well as a prognostic marker and emerged as an independent risk factor for mortality in COVID-19 patients. Hyperferritinemia and anemia, both, are inexorably interlinked in addition to having a role, directly or indirectly in the disease pathophysiology. Ferritin and hemoglobin, hence should be seen as two sides of the same coin rather than as two discrete entities. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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