Ferritin as a marker of severity in COVID-19 patients: A fatal correlation

Shani Dahan, Gad Segal, Itai Katz, Tamer Hellou, Michal Tietel, Gabriel Bryk, Howard Amital, Yehuda Shoenfeld, Amir Dagan

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Ferritin, the cellular protein storage for iron, has emerged as a key molecule in the immune system, orchestrating the cellular defense against inflammation. At the end of 2019, the novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) rapidly spread throughout China and other countries around the world, resulting in a viral pandemic. Objectives: To evaluate the correlation between ferritin and disease severity in coronavirus disease-2019 (COVID-19). Methods: In this cross-sectional study, we obtained clinical and laboratory data regarding 39 hospitalized patients with confirmed COVID-19 from two hospitals in Israel. Results: A significant increase in ferritin levels was demonstrated in patients with moderate and severe disease, compared to patients with mild disease (P = 0.006 and 0.005, respectively). Severe patients had significantly higher levels of ferritin (2817.6 ng/ml) than non-severe patients (708.6 ng/ml) P=0.02. Conclusions: In this preliminary cross-sectional study, elevated ferritin levels were shown to correlate with disease severity in 39 patients from Israel with confirmed COVID-19 infection. Our results further strengthen the hypothesis that severe COVID-19 disease might be due to an underlying dysregulated hyperimmune response. In order to identify these patients early and prioritized resources, we believe that all patients with COVID-19 should be screened for hyperferritinemia.

Original languageEnglish
Pages (from-to)429-434
Number of pages6
JournalIsrael Medical Association Journal
Volume22
Issue number8
StatePublished - Aug 2020

Keywords

  • Autoimmunity
  • Coronavirus disease-2019 (COVID-19)
  • Ferritin
  • Hyperferritinemic syndrome
  • Macrophage activating syndrome (MAS)

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