Serum ferritin-procalcitonin ratio as a predictor of outcomes in hospitalized patients with COVID-19 pneumonia
Abstract Background To identify the correlation between the ferritin-procalcitonin ratio and clinical outcomes including inhospital mortality and the requirement for mechanical ventilation in patients hospitalized with COVID-19. Methods This is a prospective observational cohort study, conducted on...
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SpringerOpen
2025-05-01
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| Series: | The Egyptian Journal of Bronchology |
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| Online Access: | https://doi.org/10.1186/s43168-025-00403-4 |
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| author | Soliman Belal Soliman Salwa Hassan Ahmed Hanan El-Sayed Zaghla Mohanad Zakarya Mohamed Shaaban Mousa Osama Amin Abdelhamid |
| author_facet | Soliman Belal Soliman Salwa Hassan Ahmed Hanan El-Sayed Zaghla Mohanad Zakarya Mohamed Shaaban Mousa Osama Amin Abdelhamid |
| author_sort | Soliman Belal Soliman |
| collection | DOAJ |
| description | Abstract Background To identify the correlation between the ferritin-procalcitonin ratio and clinical outcomes including inhospital mortality and the requirement for mechanical ventilation in patients hospitalized with COVID-19. Methods This is a prospective observational cohort study, conducted on 60 patients diagnosed with COVID-19 admitted to the intensive care units of Kasr Al Ainy University Hospital. All patients had positive PCR results for COVID-19. All patients were assessed regarding the following inflammatory markers (CRP, ferritin, procalcitonin) and also the serum-ferritin procalcitonin ratio on days 1, 3, and 7 after hospital admission. Results There was no statistically significant difference between survivors and non-survivors regarding age, gender, and clinical presentations, but there was a statistically significant difference between the two groups regarding respiratory rate, oxygen saturation, initial FIO2 support (P-value 0.028, < 0.001, < 0.001, respectively), and CRP and ferritin at day 3 (P-value 0.007). Also, regarding platelets, lymphocytes and neutrophil/lymphocyte ratio (P-value 0.034, 0.008, 0.002, respectively). As regards procalcitonin at day 3, there was a statistically significant difference between the two groups (P-value 0.002). Although the median ferritin-procalcitonin ratio (FPR) levels were lower in non-survivors’ patients than survivors at day 1 and day 3, there was no statistical significance between the two groups at day 1 and day 3. By using ROC for the prediction of mortality using ferritin and PCT at day 1, in ferritin at day 1, the best cutoff value was 640 ng/mL with sensitivity = 73.7% and specificity = 60%, while, in procalcitonin at day 1, the best cutoff value was 0.181 ng/mL with sensitivity = 8 0% and specificity = 66.7%. Conclusions FPR, which is a simple analysis, can be used to predict disease severity and prognosis of COVID-19. It could be used as an alarming sign of high-risk mortality patients as FPR is inversely proportionate to COVID-19 severity. Procalcitonin is a good predictor for mechanical ventilation and mortality in COVID-19 patients. Ferritin is a poor predictor for mechanical ventilation and a good predictor for mortality in COVID-19 patients. D-dimer, IL-6, and neutrophil–lymphocyte ratio were good predictors, while CRP was a bad predictor for mortality in COVID-19 patients. |
| format | Article |
| id | doaj-art-bd3898e5e98540b4b9dc0d39b75455a2 |
| institution | OA Journals |
| issn | 2314-8551 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | SpringerOpen |
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| series | The Egyptian Journal of Bronchology |
| spelling | doaj-art-bd3898e5e98540b4b9dc0d39b75455a22025-08-20T01:49:44ZengSpringerOpenThe Egyptian Journal of Bronchology2314-85512025-05-0119111010.1186/s43168-025-00403-4Serum ferritin-procalcitonin ratio as a predictor of outcomes in hospitalized patients with COVID-19 pneumoniaSoliman Belal Soliman0Salwa Hassan Ahmed1Hanan El-Sayed Zaghla2Mohanad Zakarya3Mohamed Shaaban Mousa4Osama Amin Abdelhamid5Department of Critical Care Medicine, Faculty of Medicine, Cairo UniversityDepartment of Internal Medicine and Clinical Hematology, Faculty of Medicine, Cairo UniversityDepartment of Critical Care Medicine, Faculty of Medicine, Cairo UniversityDepartment of Critical Care Medicine, Faculty of Medicine, Cairo UniversityDepartment of Pulmonary Medicine, Faculty of Medicine, Cairo UniversityDepartment of Critical Care Medicine, Faculty of Medicine, Cairo UniversityAbstract Background To identify the correlation between the ferritin-procalcitonin ratio and clinical outcomes including inhospital mortality and the requirement for mechanical ventilation in patients hospitalized with COVID-19. Methods This is a prospective observational cohort study, conducted on 60 patients diagnosed with COVID-19 admitted to the intensive care units of Kasr Al Ainy University Hospital. All patients had positive PCR results for COVID-19. All patients were assessed regarding the following inflammatory markers (CRP, ferritin, procalcitonin) and also the serum-ferritin procalcitonin ratio on days 1, 3, and 7 after hospital admission. Results There was no statistically significant difference between survivors and non-survivors regarding age, gender, and clinical presentations, but there was a statistically significant difference between the two groups regarding respiratory rate, oxygen saturation, initial FIO2 support (P-value 0.028, < 0.001, < 0.001, respectively), and CRP and ferritin at day 3 (P-value 0.007). Also, regarding platelets, lymphocytes and neutrophil/lymphocyte ratio (P-value 0.034, 0.008, 0.002, respectively). As regards procalcitonin at day 3, there was a statistically significant difference between the two groups (P-value 0.002). Although the median ferritin-procalcitonin ratio (FPR) levels were lower in non-survivors’ patients than survivors at day 1 and day 3, there was no statistical significance between the two groups at day 1 and day 3. By using ROC for the prediction of mortality using ferritin and PCT at day 1, in ferritin at day 1, the best cutoff value was 640 ng/mL with sensitivity = 73.7% and specificity = 60%, while, in procalcitonin at day 1, the best cutoff value was 0.181 ng/mL with sensitivity = 8 0% and specificity = 66.7%. Conclusions FPR, which is a simple analysis, can be used to predict disease severity and prognosis of COVID-19. It could be used as an alarming sign of high-risk mortality patients as FPR is inversely proportionate to COVID-19 severity. Procalcitonin is a good predictor for mechanical ventilation and mortality in COVID-19 patients. Ferritin is a poor predictor for mechanical ventilation and a good predictor for mortality in COVID-19 patients. D-dimer, IL-6, and neutrophil–lymphocyte ratio were good predictors, while CRP was a bad predictor for mortality in COVID-19 patients.https://doi.org/10.1186/s43168-025-00403-4FerritinProcalcitoninFerritin-procalcitonin ratioCOVID-19COVID pneumonia |
| spellingShingle | Soliman Belal Soliman Salwa Hassan Ahmed Hanan El-Sayed Zaghla Mohanad Zakarya Mohamed Shaaban Mousa Osama Amin Abdelhamid Serum ferritin-procalcitonin ratio as a predictor of outcomes in hospitalized patients with COVID-19 pneumonia The Egyptian Journal of Bronchology Ferritin Procalcitonin Ferritin-procalcitonin ratio COVID-19 COVID pneumonia |
| title | Serum ferritin-procalcitonin ratio as a predictor of outcomes in hospitalized patients with COVID-19 pneumonia |
| title_full | Serum ferritin-procalcitonin ratio as a predictor of outcomes in hospitalized patients with COVID-19 pneumonia |
| title_fullStr | Serum ferritin-procalcitonin ratio as a predictor of outcomes in hospitalized patients with COVID-19 pneumonia |
| title_full_unstemmed | Serum ferritin-procalcitonin ratio as a predictor of outcomes in hospitalized patients with COVID-19 pneumonia |
| title_short | Serum ferritin-procalcitonin ratio as a predictor of outcomes in hospitalized patients with COVID-19 pneumonia |
| title_sort | serum ferritin procalcitonin ratio as a predictor of outcomes in hospitalized patients with covid 19 pneumonia |
| topic | Ferritin Procalcitonin Ferritin-procalcitonin ratio COVID-19 COVID pneumonia |
| url | https://doi.org/10.1186/s43168-025-00403-4 |
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