Ferritin in the coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis.

Abstract

OBJECTIVE:

The coronavirus disease 2019 (COVID-19) has rapidly developed into a pandemic. Increased levels of ferritin due to cytokine storm and secondary hemophagocytic lymphohistiocytosis were found in severe COVID-19 patients. Therefore, the aim of this study was to determine the role of ferritin in COVID-19.

METHODS:

Studies investigating ferritin in COVID-19 were collected from PubMed, EMBASE, CNKI, SinoMed, and WANFANG. A meta-analysis was performed to compare the ferritin level between different patient groups: non-survivors versus survivors; more severe versus less severe; with comorbidity versus without comorbidity; ICU versus non-ICU; with mechanical ventilation versus without mechanical ventilation.

RESULTS:

A total of 52 records involving 10 614 COVID-19-confirmed patients between December 25, 2019, and June 1, 2020, were included in this meta-analysis, and 18 studies were included in the qualitative synthesis. The ferritin level was significantly increased in severe patients compared with the level in non-severe patients [WMD 397.77 (95% CI 306.51-489.02), P < .001]. Non-survivors had a significantly higher ferritin level compared with the one in survivors [WMD 677.17 (95% CI 391.01-963.33), P < .001]. Patients with one or more comorbidities including diabetes, thrombotic complication, and cancer had significantly higher levels of ferritin than those without (P < .01). Severe acute liver injury was significantly associated with high levels of ferritin, and its level was associated with intensive supportive care, including ICU transfer and mechanical ventilation.

CONCLUSIONS:

Ferritin was associated with poor prognosis and could predict the worsening of COVID-19 patients.

• Authors: Linlin Cheng, Haolong Li, Liubing Li, Chenxi Liu, Songxin Yan, Haizhen Chen, Yongzhe Li
• Journal: Journal of clinical laboratory analysis (J Clin Lab Anal) Vol. 34 Issue 10 Pg. e23618 (Oct 2020) ISSN: 1098-2825 [Electronic] United States
• PMID: 33078400 (Publication Type: Journal Article, Meta-Analysis, Systematic Review)
• Copyright: © 2020 The Authors. Journal of Clinical Laboratory Analysis Published by Wiley Periodicals LLC.

Chemical References

• Ferritins

Topics

• Adult
• Aged
• Aged, 80 and over
• Betacoronavirus
• COVID-19
• Comorbidity
• Coronavirus Infections (blood, diagnosis, epidemiology, mortality)
• Female
• Ferritins (blood)
• Humans
• Male
• Middle Aged
• Pandemics
• Pneumonia, Viral (blood, diagnosis, epidemiology, mortality)
• Prognosis
• SARS-CoV-2