Serum Ferritin as a Predictor of Hospital Mortality in Critically Ill COVID-19 Patients

Serum ferritin levels increase in severe COVID-19 patients. However, few data correlating the sensitivity and specificity of ferritin levels and mortality prediction in COVID-19 exist. The current study aims to investigate the sensitivity and specificity of ferritin for the prediction of mortality risks relative to COVID-19. Retrospectively, critically ill COVID-19 patients admitted to the general intensive care unit (ICU) of Ankara Bilkent City Hospital, Türkiye, were examined. The median baseline ferritin level in the survivor group was 184.7 µg/L (90.1–430.7), while it was 297.0 µg/L (150.3–851.3) in the deceased group (p = 0.001). The median maximum ferritin in the survivor group was 486.6 µg/L (187.9–1020.0), while it was 1456.7 µg/L (578.5–4388.1) in the deceased group (p < 0.001). In the receiver operating characteristic (ROC) curve analysis, the cut-off baseline ferritin value was 201.5 µg/L for the prediction of mortality (area under the curve [AUC] = 0.615, p < 0.001, 95% Confidence interval [CI]: 0.557–0.671). Baseline ferritin levels were associated with increased in-hospital mortality (p < 0.001, odds ratio: 2.347, 95% CI: 1.5–3.7). Baseline ferritin exhibited 66% sensitivity and 54.2% specificity in predicting mortality. The maximum ferritin cut-off value was 878.6 µg/L (AUC = 0.754, p < 0.001, 95% CI: 0.701–0.802), exhibiting 68% sensitivity and 73.2% specificity for mortality prediction. Ferritin has a moderately effective prediction potential for mortality in COVID-19 patients admitted to the ICU.