Revealing ferritin's significance: A prognostic marker in COVID-19 at a tertiary care hospital in Rawalpindi

Abstract

Amid the global COVID-19 crisis with over 762 million cases by 2023, reaching 775 million by 2024, this study examines the critical role of ferritin in diagnosing and managing COVID19, emphasizing its correlation with disease severity and patient outcomes, especially in Pakistan, where data is scarce. At Benazir Bhutto Hospital in Rawalpindi, this study analyzed medical records of 376 COVID-19 patients aged 25-87 between April 2020 to August 2021, categorizing them by severity. Biochemical parameters, as well as ferritin, AST, ALT, urea, creatinine, and LDH, be assessed using Beckman Coulter AU480, with group differences analyzed via nonparametric tests and SPSS 25. Among 376 patients, predominantly aged 45- 65 with a male majority (56.6%), 88.2% had comorbidities and 34.8% deceased during hospitalization. Elevated levels of ferritin, AST, urea, creatinine, and LDH were strongly linked to mortality (p < 0.001). The patients in the 66-90 age group had significantly increased risk of death from COVID-19 than those aged 45-65, by an adjusted odds ratio (AOR = 4.973; 95% CI: 2.517, 9.826; p = 0.0001). Additionally, individuals in the upper ferritin tertile were more susceptible to death, with an AOR of 3.443(95% CI: 2.012, 5.892; p = 0.0001) in contrast to those in middle and lower ferritin tertiles. These findings underscore the predictive value of age and ferritin levels in COVID-19 mortality. Increased ferritin levels stand out as a vital indicator, along with age, for forecasting mortality in COVID-19 patients, highlighting the pressing need for prompt intervention and customized treatment approaches.