TY - JOUR
AU - Liu, Alexander
AU - Hammond, Robert
AU - Chan, Kenneth
AU - Chukwuenweniwe, Chukwugozie
AU - Johnson, Rebecca
AU - Khair, Duaa
AU - Duck, Eleanor
AU - Olubodun, Oluwaseun
AU - Barwick, Kristian
AU - Banya, Winston
AU - Stirrup, James
AU - Donnelly, Peter D.
AU - Kaski, Juan Carlos
AU - Coates, Anthony R.M.
PY - 2023
DA - October
TI - Characterisation of ferritin–lymphocyte ratio in COVID-19
JO - Biomedicines
VL - 11
IS - 10
DO - https://doi.org/10.3390/biomedicines11102819
AB - Introduction: The ferritin–lymphocyte ratio (FLR) is a novel inflammatory biomarker for the assessment of acute COVID-19 patients. However, the prognostic value of FLR for predicting adverse clinical outcomes in COVID-19 remains unclear, which hinders its clinical translation. Methods: We characterised the prognostic value of FLR in COVID-19 patients, as compared to established inflammatory markers. Results: In 217 study patients (69 years [IQR: 55–82]; 60% males), FLR was weakly correlated with CRP (R = 0.108, p = 0.115) and white cell count (R = −0.144; p = 0.034). On ROC analysis, an FLR cut-off of 286 achieved a sensitivity of 86% and a specificity of 30% for predicting inpatient mortality (AUC 0.60, 95% CI: 0.53–0.67). The negative predictive values of FLR for ruling out mortality, non-invasive ventilation requirement and critical illness (intubation and/or ICU admission) were 86%, 85% and 93%, respectively. FLR performed similarly to CRP (AUC 0.60 vs. 0.64; p = 0.375) for predicting mortality, but worse than CRP for predicting non-fatal outcomes (all p &lt; 0.05). On Kaplan–Meier analysis, COVID-19 patients with FLR values &gt; 286 had worse inpatient survival than patients with FLR ≤ 286, p = 0.041. Conclusions: FLR has prognostic value in COVID-19 patients, and appears unrelated to other inflammatory markers such as CRP and WCC. FLR exhibits high sensitivity and negative predictive values for adverse clinical outcomes in COVID-19, and may be a good “rule-out” test. Further work is needed to improve the sensitivity of FLR and validate its role in prospective studies for guiding clinical management.
PB - MDPI
UR - http://hdl.handle.net/10023/28542
KW - Coronavirus (COVID-19)
ER