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Background <p>To identify the correlation between the ferritin-procalcitonin ratio and clinical outcomes including inhospital mortality and the requirement for mechanical ventilation in patients hospitalized with COVID-19.</p> Methods <p>This is a prospective observational cohort study, conducted on 60 patients diagnosed with COVID-19 admitted to the intensive care units of Kasr Al Ainy University Hospital. All patients had positive PCR results for COVID-19. All patients were assessed regarding the following inflammatory markers (CRP, ferritin, procalcitonin) and also the serum-ferritin procalcitonin ratio on days 1, 3, and 7 after hospital admission.</p> Results <p>There was no statistically significant difference between survivors and non-survivors regarding age, gender, and clinical presentations, but there was a statistically significant difference between the two groups regarding respiratory rate, oxygen saturation, initial FIO2 support (<i>P</i>-value 0.028, &lt; 0.001, &lt; 0.001, respectively), and CRP and ferritin at day 3 (<i>P</i>-value 0.007). Also, regarding platelets, lymphocytes and neutrophil/lymphocyte ratio (<i>P</i>-value 0.034, 0.008, 0.002, respectively). As regards procalcitonin at day 3, there was a statistically significant difference between the two groups (<i>P</i>-value 0.002). Although the median ferritin-procalcitonin ratio (FPR) levels were lower in non-survivors’ patients than survivors at day 1 and day 3, there was no statistical significance between the two groups at day 1 and day 3.</p> <p>By using ROC for the prediction of mortality using ferritin and PCT at day 1, in ferritin at day 1, the best cutoff value was 640&#xa0;ng/mL with sensitivity = 73.7% and specificity = 60%, while, in procalcitonin at day 1, the best cutoff value was 0.181&#xa0;ng/mL with sensitivity = 8 0% and specificity = 66.7%.</p> Conclusions <p>FPR, which is a simple analysis, can be used to predict disease severity and prognosis of COVID-19. It could be used as an alarming sign of high-risk mortality patients as FPR is inversely proportionate to COVID-19 severity. Procalcitonin is a good predictor for mechanical ventilation and mortality in COVID-19 patients. Ferritin is a poor predictor for mechanical ventilation and a good predictor for mortality in COVID-19 patients. D-dimer, IL-6, and neutrophil–lymphocyte ratio were good predictors, while CRP was a bad predictor for mortality in COVID-19 patients.</p>

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Serum ferritin-procalcitonin ratio as a predictor of outcomes in hospitalized patients with COVID-19 pneumonia

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年5月9日

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  • Soliman Belal Soliman,
  • Salwa Hassan Ahmed,
  • Hanan El-Sayed Zaghla,
  • Mohanad Zakarya,
  • Mohamed Shaaban Mousa,
  • Osama Amin Abdelhamid

摘要

Background

To identify the correlation between the ferritin-procalcitonin ratio and clinical outcomes including inhospital mortality and the requirement for mechanical ventilation in patients hospitalized with COVID-19.

Methods

This is a prospective observational cohort study, conducted on 60 patients diagnosed with COVID-19 admitted to the intensive care units of Kasr Al Ainy University Hospital. All patients had positive PCR results for COVID-19. All patients were assessed regarding the following inflammatory markers (CRP, ferritin, procalcitonin) and also the serum-ferritin procalcitonin ratio on days 1, 3, and 7 after hospital admission.

Results

There was no statistically significant difference between survivors and non-survivors regarding age, gender, and clinical presentations, but there was a statistically significant difference between the two groups regarding respiratory rate, oxygen saturation, initial FIO2 support (P-value 0.028, < 0.001, < 0.001, respectively), and CRP and ferritin at day 3 (P-value 0.007). Also, regarding platelets, lymphocytes and neutrophil/lymphocyte ratio (P-value 0.034, 0.008, 0.002, respectively). As regards procalcitonin at day 3, there was a statistically significant difference between the two groups (P-value 0.002). Although the median ferritin-procalcitonin ratio (FPR) levels were lower in non-survivors’ patients than survivors at day 1 and day 3, there was no statistical significance between the two groups at day 1 and day 3.

By using ROC for the prediction of mortality using ferritin and PCT at day 1, in ferritin at day 1, the best cutoff value was 640 ng/mL with sensitivity = 73.7% and specificity = 60%, while, in procalcitonin at day 1, the best cutoff value was 0.181 ng/mL with sensitivity = 8 0% and specificity = 66.7%.

Conclusions

FPR, which is a simple analysis, can be used to predict disease severity and prognosis of COVID-19. It could be used as an alarming sign of high-risk mortality patients as FPR is inversely proportionate to COVID-19 severity. Procalcitonin is a good predictor for mechanical ventilation and mortality in COVID-19 patients. Ferritin is a poor predictor for mechanical ventilation and a good predictor for mortality in COVID-19 patients. D-dimer, IL-6, and neutrophil–lymphocyte ratio were good predictors, while CRP was a bad predictor for mortality in COVID-19 patients.