SARS-CoV-2 infection has spread worldwide, and the pathogenic mechanism is still under investigation. The presence of a huge inflammatory response, defined as “cytokine storm,” is being studied in order to understand what might be the prognostic factors implicated in the progression of the infection, with ferritin being one of such markers. The role of ferritin as a marker of inflammation is already known, and whether it changes differently between COVID and non-COVID patients still remains unclear. The aim of this retrospective analysis is to understand whether the inflammatory process in these two types is different. In this retrospective analysis, we compared 17 patients affected by SARS-CoV-2, who had been admitted between February and April 2020 (group A) along with 30 patients admitted for acute surgical disease with SARS-CoV-2 negative swab (group B). A further subgroup of Covid negative patients with leukocytosis was compared to group A. In group A, the median (interquartile range) serum ferritin was 674 (1284) ng/mL, and it was double the cutoff (300 ng/mL) in 9 out of 17 (52%). The median (IQR) value of ferritin level in the total blood samples of group B was 231, and in the subgroup with leucocytosis, 149 (145). Group A showed a significantly higher ferritin median level compared to the entire group B (two-tailed Mann-Whitney test, p < 0.0001) as well as to the subgroup with leucocytosis (p < 0.0014). The role of iron metabolism appears to be directly involved in COVID infection. On the other hand, in the acute inflammation of patients admitted for surgery, and probably in other common phlogistic processes, iron modifications appear to be self-limited. However, our finding suggests the use of ferritin as a marker for COVID infection.

中文翻译：

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炎症中的血清铁蛋白水平：COVID-19 与急诊外科非 COVID-19 患者之间的回顾性比较分析

SARS-CoV-2感染已在全球范围内传播，其致病机制仍在研究中。人们正在研究被定义为“细胞因子风暴”的巨大炎症反应的存在，以了解感染进展中可能涉及的预后因素，铁蛋白就是此类标志物之一。铁蛋白作为炎症标志物的作用已为人所知，但它在新冠肺炎患者和非新冠患者之间是否存在不同的变化仍不清楚。本回顾性分析的目的是了解这两种类型的炎症过程是否不同。在这项回顾性分析中，我们比较了 2020 年 2 月至 4 月期间入院的 17 名 SARS-CoV-2 患者（A 组）以及 30 名因急性外科疾病入院且 SARS-CoV-2 拭子呈阴性的患者（B 组） ）。将白细胞增多的 Covid 阴性患者的另一个亚组与 A 组进行比较。在 A 组中，血清铁蛋白中位数（四分位数范围）为 674 (1284) ng/mL，是 9 年内临界值 (300 ng/mL) 的两倍。共 17 名 (52%)。B组全血样本中铁蛋白水平的中位值(IQR)为231，白细胞增多亚组为149(145)。与整个 B 组（双尾 Mann-Whitney 检验，p < 0.0001）以及白细胞增多亚组（p < 0.0014）相比，A 组显示出显着更高的铁蛋白中位水平。铁代谢的作用似乎直接参与新冠病毒感染。另一方面，在接受手术的患者的急性炎症中，以及可能在其他常见的炎症过程中，铁的改变似乎是自限性的。然而，我们的发现建议使用铁蛋白作为新冠病毒感染的标记物。