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Research ArticleOriginal Article
Open Access

Predictive value of ferritin, glucose, urea, and creatinine for COVID-19 severity and mortality in patients from Asir, Saudi Arabia

Ahmad A. Shaikh, Turki A. Mubasher, Mohammed H. Makkawi and Sultan Z. Alasmari
Saudi Medical Journal August 2023, 44 (8) 773-781; DOI: https://doi.org/10.15537/smj.2023.44.8.20230162
Ahmad A. Shaikh
From the the Department of Clinical Laboratory Sciences (Shaikh, Makkawi, Alasmari), Faculty of Applied Medical Sciences, King Khalid University, and from the Department of Clinical Laboratory (Mubasher), Asir Central Hospital, Abha, Kingdom of Saudi Arabia.
MSc, PhD
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  • ORCID record for Ahmad A. Shaikh
  • For correspondence: [email protected]
Turki A. Mubasher
From the the Department of Clinical Laboratory Sciences (Shaikh, Makkawi, Alasmari), Faculty of Applied Medical Sciences, King Khalid University, and from the Department of Clinical Laboratory (Mubasher), Asir Central Hospital, Abha, Kingdom of Saudi Arabia.
MSc
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Mohammed H. Makkawi
From the the Department of Clinical Laboratory Sciences (Shaikh, Makkawi, Alasmari), Faculty of Applied Medical Sciences, King Khalid University, and from the Department of Clinical Laboratory (Mubasher), Asir Central Hospital, Abha, Kingdom of Saudi Arabia.
MSc, PhD
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Sultan Z. Alasmari
From the the Department of Clinical Laboratory Sciences (Shaikh, Makkawi, Alasmari), Faculty of Applied Medical Sciences, King Khalid University, and from the Department of Clinical Laboratory (Mubasher), Asir Central Hospital, Abha, Kingdom of Saudi Arabia.
MSc, PhD
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  • Figure 1
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    Figure 1

    - Demographic and clinical characteristics of coronavirus disease-19 (COVID-19) patients. A) Pie chart showing gender distribution of COVID-19 patients. B) Pie chart showing age distribution of COVID-19 patients. C) Pie chart showing ABO blood group distribution of COVID-19 patients. D) Pie chart showing Rh blood group distribution of COVID-19 patients. E) Pie chart showing distribution of comorbidities among COVID-19 patients.

  • Figure 2
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    Figure 2

    - Column bar graphs comparing ferritin, glucose, urea, and creatinine among COVID-19 positive patients. A) Column bar graph comparing ferritin, glucose, urea, and creatinine among non-intensive care unit (ICU)- and ICU-admitted coronavirus disease-19 (COVID-19)-positive patients. The mean ferritin was 1165±636.9 vs. 867.7±642.4 (p=0.004), glucose was 192.5±81.27 vs. 178.2±95.05 (p=0.17), urea was 119.3±92.07 vs. 67.75±66.77 (p=0.0001), and creatinine was 2.020±18.12 vs. 1.560±2.021 (p=0.042) in ICU-admitted versus non-ICU patients. B) Column bar graph comparing ferritin, glucose, urea, and creatinine among non-survivor and survivor COVID-19-positive patients. The mean values of these markers in non-survivors and survivors were: 1141±673.2 vs. 897.6±619.1 (p=0.021) for ferritin, 211.9±86.21 vs. 162.5±85.29 (p=0.0001) for glucose, 141.7±92.20 vs. 50.51±44.35 (p=0.0001) for urea, and 2.502±1.994 vs. 1.174±1.669 (p=0.0001) for creatinine. P-values were calculated with the unpaired Student’s T-test. *P<0.05, **p<0.01, ***p<0.001, ****p<0.0001, ns: non-significant

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    Figure 3

    - Receiver operating characteristic (ROC) curve analysis of age, ferritin, glucose, urea, and creatinine across coronavirus disease-19 (COVID-19)-positive patients. A) Intensive care unit (ICU) admission is considered a positive actual state. Receiver operating characteristic curve analysis in non-ICU-admitted vs. ICU-admitted gave the area under the curve (AUC) values of 0.536 for age (p=0.283), 0.637 for ferritin (p=0.003), 0.573 for glucose (p=0.029), 0.703 for urea (p<0.0001), and 0.657 for creatinine (p<0.0001). B) Non-survivor is considered a positive actual state. Receiver operating characteristic curve analysis in survivors vs. non-survivors gave AUC values of 0.685 for age (p<0.0001), 0.610 for ferritin (p=0.0187), 0.681 for glucose (p<0.0001), 0.856 for urea (p<0.0001), and 0.823 for creatine (p<0.0001).

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    Table 1

    - Comparison of demographics, clinical characteristics, and blood group between non-intensive care unit-admitted and intensive care unit-admitted coronavirus disease-19 patients.

    VariablesICU admittedP-values
    NoYes
    Gender
    Male108 (68.8)-----100 (73.0)-----0.42†
    Female49 (31.2)-----37 (27.0)-----
    Age (year)
    All157 (53.4)58.24±19.37137 (46.6)60.51±17.440.30*
    1-206 (3.8)14.5±6.95 (3.6)11.60±8.500.54*
    21-4024 (15.3)33.80±5.2514 (10.2)34.00±5.710.90*
    41-6049 (31.2)49.19±6.2243(31.4)53.84±4.510.0002*
    >6078 (49.7)74.51±9.1775 (54.7)72.55±8.380.17*
    Blood groups
    O84 (53.5)-----77 (56.2)-----0.89†
    A55 (35.0)-----48 (35.0)-----
    B15 (9.5)-----10 (7.3)-----
    AB3 (2)-----2 (1.5)-----
    Rh
    Rh +148 (94.3)-----126 (92.0)-----0.43†
    Rh -9 (5.7)-----11 (8.0)-----
    Comorbidities
    Diabetes mellitus17 (46.0)-----20 (54.0)-----0.39†
    Hypertension14 (66.7)-----7 (33.3)-----0.31†
    Heart disease4 (57.2)-----3 (42.8)-----0.89†
    Renal disease8 (57.2)-----6 (42.8)-----0.85†
    • Values are presented as numbers and percentages (%); mean±standard deviation (SD).

    • ↵* Independent T-test.

    • ↵† Chi-square test. ICU: intensive care unit

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    Table 2

    - Comparison of demographics, clinical characteristics, and blood group between non-survivor and survivor coronavirus disease-19 patients.

    VariablesMortalityP-values
    No Yes 
    Gender
    Male116 (55.8)-----92 (44.2)-----0.58†
    Female45 (52.3)-----41 (47.7)-----
    Age (year)
    All161 (54.8)53.96±19.55133 (45.2)65.77±15.770.0001*
    1-209 (5.6)13.50±7.032 (1.5)8.50±10.610.42*
    21-4034 (21.1)34.24±5.074 (3.0)30.75±7.500.22*
    41-6056 (34.8)50.02±5.9136 (27.1)53.56±5.340.004*
    >6062 (38.5)74.10±8.6091 (68.4)73.40±9.270.63*
    Blood groups
    O86 (53.4)-----75 (56.4)-----0.69†
    A57 (35.4)-----46 (34.6)-----
    B14 (8.7)-----11 (8.3)-----
    AB4 (2.5)-----1 (0.7)-----0.17†
    Rh +153 (55.8)-----121 (44.2)-----
    Rh -8 (40.0)-----12 (60.0)-----
    Comorbidities
    Diabetes mellitus17 (45.9)-----20 (54.0)-----0.59†
    Hypertension12 (57.1)-----9 (42.9)-----0.32†
    Heart disease3 (42.9)-----4 (57.1)-----0.87†
    Renal disease5 (35.7)-----9 (64.3)-----0.54†
    • Values are presented as numbers and percentages (%); mean ± standard deviation (SD).

    • ↵* Independent T-test.

    • ↵† Chi-square test.

    • View popup
    Table 3

    - Association of gender, age, ferritin, glucose, urea, and creatinine with intensive care unit admission and mortality among coronavirus disease-19 patients.

    VariableICU-admissionMortality
     P-values P-values
    Gender0.815 (0.489-1.350)0.42971.174 (0.707-1.946)0.5327
    Age0.993 (0.981-1.006)0.29940.963 (0.948-0.976)0.0001
    Ferritin0.999 (0.998-0.999)0.00550.999 (0.998-0.999)0.0149
    Glucose0.995 (0.998-1.001)0.17160.993 (0.990-0.996)0.0001
    Urea0.991 (0.987-0.994)0.00010.976 (0.970-0.982)0.0001
    Creatinine0.877 (0.763-0.993)0.05020.556 (0.442-0.682)0.0001
    • Values are presented as odds ratio (OR) 95% confidence interval, ICU: intensive care unit

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Predictive value of ferritin, glucose, urea, and creatinine for COVID-19 severity and mortality in patients from Asir, Saudi Arabia
Ahmad A. Shaikh, Turki A. Mubasher, Mohammed H. Makkawi, Sultan Z. Alasmari
Saudi Medical Journal Aug 2023, 44 (8) 773-781; DOI: 10.15537/smj.2023.44.8.20230162

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Predictive value of ferritin, glucose, urea, and creatinine for COVID-19 severity and mortality in patients from Asir, Saudi Arabia
Ahmad A. Shaikh, Turki A. Mubasher, Mohammed H. Makkawi, Sultan Z. Alasmari
Saudi Medical Journal Aug 2023, 44 (8) 773-781; DOI: 10.15537/smj.2023.44.8.20230162
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Keywords

  • COVID-19
  • mortality
  • ICU-admission
  • ABO group
  • ferritin
  • urea
  • creatinine

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