Ferritin and mortality in hemodialysis patients with COVID-19: A systematic review and meta-analysis

Objective: To investigate the difference in serum ferritin levels between deceased and surviving regular hemodialysis patients with COVID-19. Methods: We conducted a systematic search across four databases following the PRISMA statement guidelines. Studies reporting ferritin levels and mortality of regular hemodialysis patients with COVID-19 were included. Employing the random-effects model, we performed a meta-analysis to determine the mean difference in serum ferritin levels between the studied groups, along with their corresponding 95% confidence intervals. The meta-analysis was carried out using Review Manager 5.4 and Stata 16. Results: A total of 1 013 patients from seven studies were included in this study. Our meta-analysis showed higher mean serum ferritin in the deceased compared to surviving regular hemodialysis patients with COVID-19, with a mean difference of 449.43 ng/mL [95% CI (244.07, 654.80), P<0.000 1; I2=58%, P=0.003]. Conclusions: Our study found a higher mean of serum ferritin levels in the deceased compared to surviving regular hemodialysis patients with COVID-19.