Serum Ferritin Predicts Need For Vasopressor Support And Acute Kidney Injury During Severe Covid-19

INTRODUCTION: Severe Coronavirus disease 2019 (COVID-19) has become the most common cause of ARDS in 2020 This infection is associated with systemic inflammation, need for vasopressor support and AKI Serum ferritin (Ft) is an immunomodulator-antioxidant protein consistently elevated in COVID-19 that may confer protection or accentuate the progression of the disease depending on its level We evaluated if Hyperferritinemia (Ft >2000 ng/ml) induced by COVID-19 is independently associated with need for vasopressor support and development of AKI in patients with ARDS METHODS: Retrospective Cases-Control study that included patients with moderate ARDS secondary to COVID-19 admitted to ICU Patients were categorized based on Ft as Cases [Cs] (Ft >2000 ng/ml) and Controls [Ct] (Ft 2000 ng/ml) required vasopressor support compared to 36% of the Ct (Ft 2000 ng/ml) had an ARI of 31% for vasopressor support and ARI of 30% for progression to AKI CONCLUSIONS: Our study suggest that hyperferritinemia (>2000 ng/ml) due to severe COVID-19 is strongly associated with need for vasopressor support and progression to AKI within the first 10 days of ICU admission However, the potential cytoprotective and immunomodulatory role of moderate elevation of Ft (<2000 ng/ml) deserves further investigation