• Shani Dahan, Gad Segal, Itai Katz, Tamar Hellou, Michal Tietel, Gabriel Bryk, Howard Amital, Yehuda Shoenfeld, and Amir Dagan.
• Department of Internal Medicine B, Assuta Ashdod Medical Center, Ashdod, Israel, affiliated with Ben-Gurion University of the Negev.
• Isr Med Assoc J. 2020 Aug 1; 8 (22): 429-434.

BackgroundFerritin, the cellular protein storage for iron, has emerged as a key molecule in the immune system, orchestrating the cellular defense against inflammation. At the end of 2019, the novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) rapidly spread throughout China and other countries around the world, resulting in a viral pandemic.ObjectivesTo evaluate the correlation between ferritin and disease severity in coronavirus disease-2019 (COVID-19).MethodsIn this cross-sectional study, we obtained clinical and laboratory data regarding 39 hospitalized patients with confirmed COVID-19 from two hospitals in Israel.ResultsA significant increase in ferritin levels was demonstrated in patients with moderate and severe disease, compared to patients with mild disease (P = 0.006 and 0.005, respectively). Severe patients had significantly higher levels of ferritin (2817.6 ng/ml) than non-severe patients (708.6 ng/ml) P = 0.02.ConclusionsIn this preliminary cross-sectional study, elevated ferritin levels were shown to correlate with disease severity in 39 patients from Israel with confirmed COVID-19 infection. Our results further strengthen the hypothesis that severe COVID-19 disease might be due to an underlying dysregulated hyperimmune response. In order to identify these patients early and prioritized resources, we believe that all patients with COVID-19 should be screened for hyperferritinemia.

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