Elevated serum ferritin level effectively discriminates severity illness and liver injury of coronavirus disease 2019 pneumonia

Cao, Peng; Wu, Yuanjue; Wu, Sanlan; Wu, Tingting; Zhang, Qilin; Zhang, Rui; Wang, Zhao; Zhang, Yu

AIM: Ferritin is a hepatic protein that plays vital roles in diagnosing and predicting diseases, but its potential in coronavirus disease 2019 (COVID-19) remains unknown. METHOD: We collected clinical records from 79 COVID-19 patients at Wuhan Union hospital (China). Spearman’s correlation analysis, receiver operating characteristic (ROC) curve and Kaplan–Meier survival curves were employed. RESULTS: Patients with elevated ferritin levels had a higher incidence of severity illness (50.0 vs 2.9%) and liver injury (52.3 vs 20.0%) when compared with patients with normal ferritin levels (p < 0.05). Ferritin could effectively identify the severity of illness (ROC area 0.873) and liver injury (ROC area 0.752). The elevated ferritin group showed longer viral clearance time (median 16 vs 6 days, p < 0.001) and in-hospital length (median 18 vs 10 days, p < 0.001). CONCLUSIONS: It suggests that ferritin could act as an easy-to-use tool to identify liver injury and severity illness and predict the prognosis of COVID-19 patients. Intensive surveillance is necessary for patients with abnormal ferritin levels.