Causes of hyperferritinemia: what has changed with the pandemic?
Abstract
Purpose: In this study, we aimed to analyze patients with ferritin levels of ≥ 1000 ng/mL based on diagnoses and the wards they received both before the COVID pandemic and during the pandemic periods.
Materials and Methods: This retrospective study evaluated the patients who applied to a tertiary hospital and had ferritin onset of the pandemic. The patients' demographic and clinical characteristics and ferritin levels were obtained from the hospital's medical records.
Results: There were 2022 patients, 635 (31.4%) female and 1387 (68.6%) male, with a median age of 62 (49-71) years. 554 patients (27.4%) before the pandemic, and 1468 patients (72.6%) during the pandemic had ferritin levels of ≥ 1000 ng/mL. Hyperferritinemia was detected more frequently in males during the pandemic (p<0.001). Before the pandemic, the most prevalent cause of hyperferritinemia was hematologic malignancies, while COVID-19 was the most common cause of hyperferritinemia during the pandemic. Hyperferritinemia was commonly detected in the hematology department before the pandemic, while it was frequently performed in COVID-19 clinics and intensive care units after the onset of the pandemic.
Conclusion: In the current study, the most prevalent cause of hyperferritinemia was hematological malignancies before the pandemic, and COVID-19 infection during the pandemic. Therefore, it is important to consider the most common conditions that match the patient's clinical condition when detecting extremely high ferritin values. Nevertheless, many other important clinical situations should also be kept in mind.
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- Senjo H, Higuchi T, Okada S, Takahashi O. Hyperferritinemia: causes and significance in a general hospital. Hematology. 2018;23:817-22.
- Goldhaber G, Segal G, Dagan A. Hyperferritinemia in the elderly can differentiate the bad from the worst. Medicine (Baltimore). 2020;99:e21419.
- Fauter M, Mainbourg S, El Jammal T, Guerber A, Zaepfel S, Henry T et al. Extreme hyperferritinemia: Causes and prognosis.J Clin Med. 2022;11:5438.
- Ruan Q, Yang K, Wang W, Jiang L, Song J. Correction to clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med. 2020;46:1294-97.
- Henter JI, Horne A, Aricó M, Egeler RM, Filipovich AH, Imashuku S et al. HLH-2004: Diagnostic and therapeutic guidelines for hemophagocytic lymphohistiocytosis. Pediatr Blood Cancer. 2007;48:124-31.
- Sandnes M, Ulvik RJ, Vorland M, Reikvam H. Hyperferritinemia- a clinical overview. J Clin Med. 2021;10:2008.
- VasanthiDharmalingam P, Karuppagounder V, Watanabe K et al. SARS–CoV-2 Mediated hyperferritinemia and cardiac arrest: Preliminary ınsights. Drug Discov Today. 2021;26:1265-74.
- Ellervik C, Marott JL, Tybjærg-Hansen A, Schnohr P, Nordestgaard BG. Total and cause-specific mortality by moderately and markedly increased ferritin concentrations: General population study and meta-analysis. Clin Chem. 2014;60:1419-28.
- Lachmann G, Knaak C, Vorderwülbecke G, Rosee P, Balzer F, Schenk T et al. Hyperferritinemia in critically Ill patients. Crit Care Med. 2020;48:459-65.
- Li Y, Hu Y, Yu J, Ma T. Retrospective analysis of laboratory testing in 54 patients with severe or critical type 2019 novel coronavirus pneumonia. Lab Invest. 2019;100:794-800.
