Hyperferritinemia comes to light frequently in general practice. However, the characteristics of COVID-19-associated hyperferritinemia and the relationship with the prognosis were not well described. The retrospective study included 268 documented COVID-19 patients. They were divided into the hyperferritinemia group (≥ 500 µg/L) and the non-hyperferritinemia group (< 500 µg/L). The prevalence of fever and thrombocytopenia and the proportion of patients with mechanical ventilator support and in-hospital death were much higher in the hyperferritinemia group ( P < 0.001). The hyperferritinemia patients showed higher median IL-6, D-dimer, and hsCRP ( P < 0.001) and lowered FIB level ( P = 0.036). The hyperferritinemia group had a higher proportion of patients with AKI, ARDS, and CSAC ( P < 0.001). According to the multivariate analysis, age, chronic pulmonary disease, and hyperferritinemia were found to be significant independent predictors for in-hospital mortality [HR 1.041 (95% CI 1.015–1.068), P = 0.002; HR 0.427 (95% CI 0.206–0.882), P = 0.022; HR 6.176 (95% CI 2.447–15.587), P < 0.001, respectively]. The AUROC curve was 0.88, with a cut-off value of ≥ 971 µg/L. COVID-19 patients with hyperferritinemia had a high proportion of organ dysfunction, were more likely to show hyper-inflammation, progressed to hemophagocytic lymphohistiocytosis, and indicated a higher proportion of death. Supplementary Information The online version contains supplementary material available at 10.1007/s00277-021-04735-1.
【저자키워드】 COVID-19, hemophagocytic lymphohistiocytosis, in-hospital mortality, Hyperferritinemia, 【초록키워드】 ARDS, Prognosis, IL-6, D-dimer, Prevalence, Retrospective study, hsCRP, Characteristics, Fever, Patient, mechanical ventilator, death, organ dysfunction, hyper-inflammation, age, COVID-19 patients, Analysis, In-hospital death, Support, supplementary material, 95% CI, chronic pulmonary disease, cut-off value, AUROC, described, proportion, indicated, median, much higher, independent predictor, patients with AKI, progressed, 【제목키워드】 Multiple organ damage, Hyper-inflammatory responses,