Relationship of enhanced ferritin and COVID-19 disease progression
Several studies show that ferritin levels are enhanced in COVID-19 patients. In some cases even strongly. Ferritin is an iron storage protein that is the main source of iron reserves in every cell.
Measurement of the ferritin concentration in serum determines the total amount of iron present in the body. Viruses have no metabolism of their own and require iron-dependent enzyme activities of the host cell and the supply of metabolic products for their replication. Studies have shown that in COVID-19 patients with pre-existing conditions such as diabetes, thrombosis or cancer, ferritin concentrations are greatly increased. COVID-19 patients with severely elevated ferritin levels, have a more severe disease course and higher mortality rate.
In ITS-COVID-19 patients, ferritin concentrations are above 1,000 ng/mL. The level of ferritin correlates with the severity of the clinical progression. When a ferritin concentration > 300 ng/mL is detected, the OR (odds rate) for COVID-19-related death is increased approximately 9-fold compared with a ferritin level < 300 ng/mL. To assess hyperinflammation and the likely severity of disease progression in hospitalized COVID-19 patients, early ferritin level determination is strongly recommended, including by the RKI. The organization “Mediziner4Mediziner” recommends laboratory ferritin level measurement every 48 hours in hypoxemic, non-intubated patients. Invasively ventilated patients even daily.
The measurement range of the BIOMED Ferritin Reagent is 5 to 2,000 ng/mL. Samples can be taken from serum and plasma. Reagent, calibrator and quality control are available as ferritin complete set (related to the 3rd WHO reference material NIBSC WHO 94/ 572).
The determination of the ferritin value is a so-called IGeL (Individual Health Service). The costs are not covered by the statutory health insurance, but the patient bears them himself. An early determination in connection with a COVID-19 disease could provide information about the severity of the course and the required medical care.