The detrimental impact of elevated Ferritin to Iron ratio on in-hospital prognosis of patients with COVID-19

Acute viral infections, including coronavirus disease 2019 (COVID-19), are characterized by the dysregulation of iron metabolism, resulting in high serum ferritin and low iron levels. This study aimed to evaluate the prospective impact of iron metabolism dysregulation, as expressed by serum Ferritin-to-Iron Ratio (FIR), on the in-hospital prognosis of patients with COVID-19. Serum levels of ferritin and iron, as well as other iron metabolism markers and recognized prognostic indicators of COVID-19 severity, were measured in 362 patients consecutively hospitalized for COVID-19. The prospective relationship between FIR and the risk of the composite outcome of intensive care unit (ICU) admission/in-hospital death was analyzed. In the population examined (mean age 74 ± 15 years, males 55%), the rates of radiographic signs of pneumonia, respiratory distress, and the need for noninvasive ventilation were higher in patients with high FIR (≥29.2, the 75^th percentile) than in those with low FIR (<29.2, the 75^th percentile) (p Increasing FIR values significantly and independently predicts worse in-hospital prognosis in hospitalized patients with COVID-19.

急性病毒感染（包括2019冠状病毒病（coronavirus disease 2019，COVID-19））以铁代谢紊乱为典型特征，表现为血清铁蛋白升高、血清铁水平降低。本研究旨在评估以血清铁蛋白与铁比值（serum Ferritin-to-Iron Ratio, FIR）为表征的铁代谢紊乱，对2019冠状病毒病住院患者院内预后的前瞻性影响。研究纳入362例连续收治的2019冠状病毒病住院患者，检测其血清铁蛋白、血清铁水平，以及其他铁代谢标志物与公认的COVID-19病情严重程度预后指标。分析了FIR与复合结局（入住重症监护病房（intensive care unit, ICU）/院内死亡）风险之间的前瞻性关联。在本次研究纳入的人群中（平均年龄74±15岁，男性占比55%），高FIR组（≥29.2，即第75百分位数）患者的肺炎影像学征象、呼吸窘迫发生率及无创通气需求率均高于低FIR组（<29.2，即第75百分位数）（p。FIR水平升高可显著且独立地预测2019冠状病毒病住院患者的不良院内预后。