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2021, Number 3

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Med Crit 2021; 35 (3)

Association of ferritin with ventilatory impairment and mortality due to COVID-19 in intensive care

Galicia GC, Santana HGP, Vega S?E

Language: Spanish
References: 39
Page: 121-129
PDF size: 284.16 Kb.


ABSTRACT

Introduction: The association of serum ferritin as a parameter of poor prognosis and survival has been studied in patients with COVID-19. Studies affirm a decreased survival and poor prognosis in patients with COVID and ferritin levels greater than 1,000 ng/mL. This implies that the hemoglobin is decreasing, and the heme group is increasing, therefore the body will accumulate too many harmful iron ions, which will cause inflammation in the body and increase the C-reactive protein and albumin. Cells react to stress due to inflammation, producing large amounts of serum ferritin to bind free iron ions to reduce damage. Objetive: The objective of the study was to evaluate serum ferritin measured at admission as a predictor of evolution in the ICU, for which intubation and death were taken as the main outcomes. A sensitivity and specificity calculation were performed and the area under the curve was calculated by means of the ROC curve. The strength of association of ferritin was evaluated by calculating the crude OR and adjusted by multivariate univariate logistic regression. Ferritin was evaluated as a prognostic marker of intubation and mortality in patients admitted to intensive care. Material and methods: A retrospective, cross-sectional study was carried out, in which 48 patients were recruited in the intensive care unit of the San Angel Inn University Hospital. Which were taken the clinical data and variables of interest from the clinical record. A description of the data was made based on its distribution in means with standard deviation or medians with interquartile ranges of the continuous variables and in frequencies with percentage of the categorical data. Results: For mortality it was chosen from the ROC curve with a sensitivity value of 50%, specificity 88.89, LR + of 4.5 and LR – 0.56, with it the area was 8 using this cut-off value, the proportion of patients with mortality below this value was 7.8 for mortality risk and sensitivity of 72.73%, specificity 73.08, LR + of 2.7 and LR – 0.37, with this the area was 7.2 using this The cut-off value of the proportion of patients intubated under this value was 9.3, with this a univariate logistic regression was performed, observing a crude OR of 8 and adjusted for mortality, and crude OR of 7.23 and adjusted for 9.3 for intubation and adjusted to confounders for age with OR 1.0, with p value of 0.080, hypertension with OR of 3.2, p value of 0.10 and for obesity with OR of 1.89, with p value of 0.041. Conclusion: In patients admitted to the San Angel Inn University hospital with severity criteria for intensive therapy, the presence of ferritin greater than 1100 ng / ml has a sensitivity of 72.73%, specificity of 73.08% and LR + of 2.70 and LR – of 0.37 of this value was associated with intubation with crude OR of 7.2 and adjusted of 9.3 and the presence of ferritin greater than 2507 ng / ml, it has a sensitivity of 50%, specificity of 88.89% and LR + of 4.5 and LR – of 0.56 of This value was associated with mortality with a crude OR of 8 and adjusted for 7.8. For this reason. A ferritin cut-off value greater than 1100, in patients admitted to ICU. It should be considered as a prognosis for intubation during hospitalization. This marker should be evaluated with a greater number of patients to verify its usefulness.


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