{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T17:53:46Z","timestamp":1777312426073,"version":"3.51.4"},"reference-count":62,"publisher":"Hamad bin Khalifa University Press (HBKU Press)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025]]},"abstract":"\n Background:<\/jats:bold>\n Pulmonary fibrosis is characterized by excessive matrix formation, which destroys typical lung architecture and increases the chances of comorbidity. It is essential to look into potential serum indicators for the early identification of individuals who may develop such severe fibrotic consequences since there is currently no specific marker for the early diagnosis of post-COVID-19 pulmonary fibrosis. The study is aimed at examining potential serum markers that could be used for early detection of pulmonary fibrosis in patients with COVID-19.\n <\/jats:p>\n \n Methods:<\/jats:bold>\n It is a cross-sectional retrospective observational study that included male (\n n<\/jats:italic>\n = 26) and female (\n n<\/jats:italic>\n = 10) patients who were confirmed positive for COVID-19 using the Reverse transcription polymerase chain reaction (RTPCR) test. Various hematological parameters, such as platelet count, white blood cell count (WBC count), platelet-to-lymphocyte ratio (PLR), white blood cell count to mean platelet volume ratio (WMR), red cell distribution width (RDW), plateletcrit (PCT), mean platelet volume (MPV), platelet distribution width (PDW), serum ferritin level, and CT severity scores (CT-SSs) were recorded. The association between hematological parameters, serum ferritin level, and CT-SS was assessed by the Pearson correlation test using the GraphPad Prism software (version 10).\n p<\/jats:italic>\n < 0.05 was considered statistically significant.\n <\/jats:p>\n \n Results:<\/jats:bold>\n The descriptive analysis revealed no significant correlation between platelet count (\n r<\/jats:italic>\n = 0.1610,\n p<\/jats:italic>\n = 0.3483), WBC count (\n r<\/jats:italic>\n = \u22120.1381,\n p<\/jats:italic>\n = 0.4217), PLR (\n r<\/jats:italic>\n = 0.2262,\n p<\/jats:italic>\n = 0.1847), WMR (\n r<\/jats:italic>\n = \u22120.1093,\n p<\/jats:italic>\n = 0.5258), RDW (\n r<\/jats:italic>\n = 0.05982,\n p<\/jats:italic>\n = 0.7289), PCT (\n r<\/jats:italic>\n = \u22120.059,\n p<\/jats:italic>\n = 0.752), MPV (\n r<\/jats:italic>\n = 0.046,\n p<\/jats:italic>\n = 0.788), and PDW (\n r<\/jats:italic>\n = \u22120.06,\n p<\/jats:italic>\n = 0.699) with CT-SS. However, a significant positive correlation was observed between CT-SS and serum ferritin levels in COVID-19 patients (\n r<\/jats:italic>\n = 0.5452,\n p<\/jats:italic>\n = 0.0006).\n <\/jats:p>\n \n Conclusions:<\/jats:bold>\n As there was a significant positive correlation between serum ferritin level and CT-SS, the serum ferritin level could be considered as a simple and cost-effective biomarker for predicting the development of lung fibrosis in long COVID-19 conditions after controlling the confounders.\n <\/jats:p>","DOI":"10.5339\/qmj.2025.44","type":"journal-article","created":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T06:30:48Z","timestamp":1750141848000},"source":"Crossref","is-referenced-by-count":0,"title":["Serum ferritin as a predictive marker of pulmonary fibrosis in post-COVID-19"],"prefix":"10.5339","volume":"2025","author":[{"given":"Aditya","family":"Ojha","sequence":"first","affiliation":[{"name":"K. S. Hegde Medical Academy, Nitte (Deemed to be University), Deralakatte, Mangalore, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muskan","family":"Bhasin","sequence":"additional","affiliation":[{"name":"K. S. Hegde Medical Academy, Nitte (Deemed to be University), Deralakatte, Mangalore, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megha Bhat","family":"Agni","sequence":"additional","affiliation":[{"name":"Department of Physiology, K. S. Hegde Medical Academy, Nitte (Deemed to be University), Deralakatte, Mangalore, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"KM Damodara","family":"Gowda","sequence":"additional","affiliation":[{"name":"Department of Physiology, K. S. Hegde Medical Academy, Nitte (Deemed to be University), Deralakatte, Mangalore, India"},{"name":"Department of Physiology, Siddaganga Medical College & Research Institute, Tumakuru, Karnataka-572102, India*Correspondence: KM Damodara Gowda damodar001@gmail.com"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3277","reference":[{"key":"CIT0001"},{"key":"CIT0002","series-title":"Front Microbiol","first-page":"1\u201324","article-title":"Long COVID or post-acute sequelae of COVID-19 (PASC): an overview of biological factors that may contribute to persistent symptoms","volume":"12","author":"Proal\n \nAD","year":"2021;"},{"issue":"(3)","key":"CIT0003","series-title":"Biochem Medica","first-page":"1\u201313","article-title":"Complete blood count alterations in covid-19 patients: a narrative review","volume":"31","author":"Palladino\n \nM","year":"2021;"},{"issue":"(6)","key":"CIT0004","series-title":"Cell Host Microbe","first-page":"992\u20131000","article-title":"Complex immune dysregulation in COVID-19 patients with severe respiratory failure","volume":"27","author":"Giamarellos-Bourboulis\n \nEJ","year":"2020;"},{"issue":"(5)","key":"CIT0005","series-title":"Nat Mach Intell","first-page":"283\u20138","article-title":"An interpretable mortality prediction model for COVID-19 patients","volume":"2","author":"Yan\n \nL","year":"2020;"},{"issue":"(1)","key":"CIT0006","series-title":"Crit Care","first-page":"1\u201315","article-title":"Lung fluid biomarkers for acute respiratory distress syndrome: a systematic review and meta-analysis","volume":"23","author":"Wang\n \nY","year":"2019;"},{"issue":"(35824)","key":"CIT0007","series-title":"Am J Respir Cell Mol Biol","first-page":"1\u201359","article-title":"Amicus or adversary revisited: platelets in acute lung injury & acute respiratory distress syndrome Elizabeth","author":"Middleton\n \nEA","year":"2007;"},{"key":"CIT0008","series-title":"Exp Ther Med","first-page":"2557\u201360","article-title":"Pulmonary fibrosis in the aftermath of the Covid-19 era (review)","volume":"20","author":"Vasarmidi\n \nE","year":"2020;"},{"key":"CIT0009","series-title":"Front Immunol","first-page":"1\u201317","article-title":"The impact of platelets on pulmonary microcirculation throughout COVID-19 and its persistent activating factors","volume":"13","author":"Xiang\n \nM","year":"2022;"},{"issue":"(2)","key":"CIT0010","series-title":"Thromb Res","first-page":"111\u20137","article-title":"Relevance of tissue factor and tissue factor pathway inhibitor for hypercoagulable state in the lungs of patients with idiopathic pulmonary fibrosis","volume":"99","author":"Fujii\n \nM","year":"2000;"},{"issue":"(2)","key":"CIT0011","series-title":"Clin Exp Reprod Med","first-page":"92\u20135","article-title":"Platelet volume indices in patients with varicocele","volume":"41","author":"Mahdavi-Zafarghandi\n \nR","year":"2014;"},{"key":"CIT0012","series-title":"Autoimmun Rev","first-page":"102573","article-title":"COVID-19 gone bad: a new character in the spectrum of the hyperferritinemic syndrome?","volume":"19","author":"Colafrancesco\n \nS","year":"2020;"},{"key":"CIT0013","series-title":"Int Immunol","first-page":"401\u20139","article-title":"Hyperferritinemia and inflammation","volume":"29","author":"Kernan\n \nKF","year":"2017;"},{"key":"CIT0014","series-title":"Integr Biol","first-page":"486\u2013510","article-title":"Diagnostic morphology: biophysical indicators for iron-driven inflammatory diseases","volume":"6","author":"Pretorius\n \nE","year":"2014;"},{"key":"CIT0015","series-title":"Int J Infect Dis","first-page":"303\u20135","article-title":"Iron: innocent bystander or vicious culprit in COVID-19 pathogenesis?","volume":"97","author":"Edeas\n \nM","year":"2020;"},{"key":"CIT0016","series-title":"Microsc Res Tech","first-page":"1185\u201390","article-title":"Iron enhances generation of fibrin fibers in human blood: implications for pathogenesis of stroke","volume":"75","author":"Lipinski\n \nB","year":"2012;"},{"issue":"(4)","key":"CIT0017","series-title":"Free Radic Biol Med","first-page":"457\u201363","article-title":"Ferritin, iron homeostasis, and oxidative damage","volume":"33","author":"Arosio\n \nP","year":"2002;"},{"key":"CIT0018","series-title":"Clin Epidemiol Glob Health","first-page":"101295","article-title":"Association of serum ferritin with severity and clinical outcome in COVID-19 patients: an observational study in a tertiary healthcare facility","volume":"21","author":"Kurian\n \nSJ","year":"2023;"},{"issue":"(8)","key":"CIT0019","series-title":"Clin Respir J","first-page":"2378\u201389","article-title":"Prognostic evaluation of serum ferritin in acute exacerbation of idiopathic pulmonary fibrosis","volume":"12","author":"Enomoto\n \nN","year":"2018;"},{"issue":"(4)","key":"CIT0020","series-title":"Am J Physiol Lung Cell Mol Physiol","first-page":"L487\u201399","article-title":"Investigating the role of platelets and platelet-derived transforming growth 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\nHA","year":"2018;"},{"issue":"(2)","key":"CIT0024","series-title":"Diseases","first-page":"22","article-title":"Mean platelet volume as a predictor of COVID-19 severity: a prospective cohort study in the highlands of Peru","volume":"10","author":"Quispe-Pari\n \nJF","year":"2022;"},{"issue":"(1)","key":"CIT0025","series-title":"Hear Lung Circ","first-page":"29\u201334","article-title":"Association between PDW and long term major adverse cardiac events in patients with acute coronary syndrome","volume":"25","author":"Ulucan\n \nS\u00b8","year":"2016;"},{"issue":"(4)","key":"CIT0026","series-title":"Revista Portuguesa de Pneumologia (English Edition)","first-page":"196\u2013201","article-title":"Could \u201cred cell distribution width\u201d predict COPD severity?","volume":"22","author":"Tertemiz\n \nKC","year":"2016;"},{"issue":"(11)","key":"CIT0027","series-title":"Saudi Med J","first-page":"1223\u20138","article-title":"Predictive value of platelet to lymphocyte ratio and neutrophil to lymphocyte ratio in evaluating both lung involvement and severity of patients with coronavirus disease 2019","volume":"42","author":"Aksu\n \nY","year":"2021;"},{"issue":"(10)","key":"CIT0028","series-title":"PLoS One","first-page":"1\u20138","article-title":"Increased platelet reactivity in idiopathic pulmonary fibrosis is mediated by a plasma factor","volume":"9","author":"Crooks\n \nMG","year":"2014;"},{"issue":"(7)","key":"CIT0029","series-title":"Int J Res Stud Med Heal Sci","first-page":"8\u201311","article-title":"Is mean platelet volume useful for predicting the prognosis of COVID-19 diagnosed patients?","volume":"5","author":"Aktas\n \nA","year":"2020;"},{"issue":"(4)","key":"CIT0030","series-title":"Clin Appl Thromb","first-page":"346\u201350","article-title":"Mean platelet volume as a surrogate marker for platelet activation in patients with idiopathic pulmonary fibrosis","volume":"22","author":"Ntolios\n \nP","year":"2016;"},{"issue":"(3)","key":"CIT0031","series-title":"Indian J Respir Care","first-page":"253\u201360","article-title":"Role of ferritin as \u201ccore marker\u201d in the assessment of severity, response to therapy and predicting outcome in COVID-19 pneumonia: a large, two-center, prospective, observational study of 1000 cases in tertiary care setting in India","volume":"11","author":"Patil\n \nS","year":"2022;"},{"key":"CIT0001"},{"key":"CIT0002","series-title":"Front Microbiol","first-page":"1\u201324","article-title":"Long COVID or post-acute sequelae of COVID-19 (PASC): an overview of biological factors that may contribute to persistent symptoms","volume":"12","author":"Proal\n \nAD","year":"2021;"},{"issue":"(3)","key":"CIT0003","series-title":"Biochem Medica","first-page":"1\u201313","article-title":"Complete blood count alterations in covid-19 patients: a narrative review","volume":"31","author":"Palladino\n \nM","year":"2021;"},{"issue":"(6)","key":"CIT0004","series-title":"Cell Host Microbe","first-page":"992\u20131000","article-title":"Complex immune dysregulation in COVID-19 patients with severe respiratory failure","volume":"27","author":"Giamarellos-Bourboulis\n \nEJ","year":"2020;"},{"issue":"(5)","key":"CIT0005","series-title":"Nat Mach Intell","first-page":"283\u20138","article-title":"An interpretable mortality prediction model for COVID-19 patients","volume":"2","author":"Yan\n \nL","year":"2020;"},{"issue":"(1)","key":"CIT0006","series-title":"Crit Care","first-page":"1\u201315","article-title":"Lung fluid biomarkers for acute respiratory distress syndrome: a systematic review and meta-analysis","volume":"23","author":"Wang\n \nY","year":"2019;"},{"issue":"(35824)","key":"CIT0007","series-title":"Am J Respir Cell Mol Biol","first-page":"1\u201359","article-title":"Amicus or adversary revisited: platelets in acute lung injury & acute respiratory distress syndrome Elizabeth","author":"Middleton\n \nEA","year":"2007;"},{"key":"CIT0008","series-title":"Exp Ther Med","first-page":"2557\u201360","article-title":"Pulmonary fibrosis in the aftermath of the Covid-19 era (review)","volume":"20","author":"Vasarmidi\n \nE","year":"2020;"},{"key":"CIT0009","series-title":"Front Immunol","first-page":"1\u201317","article-title":"The impact of platelets on pulmonary microcirculation throughout COVID-19 and its persistent activating factors","volume":"13","author":"Xiang\n \nM","year":"2022;"},{"issue":"(2)","key":"CIT0010","series-title":"Thromb Res","first-page":"111\u20137","article-title":"Relevance of tissue factor and tissue factor pathway inhibitor for hypercoagulable state in the lungs of patients with idiopathic pulmonary fibrosis","volume":"99","author":"Fujii\n \nM","year":"2000;"},{"issue":"(2)","key":"CIT0011","series-title":"Clin Exp Reprod Med","first-page":"92\u20135","article-title":"Platelet volume indices in patients with varicocele","volume":"41","author":"Mahdavi-Zafarghandi\n \nR","year":"2014;"},{"key":"CIT0012","series-title":"Autoimmun Rev","first-page":"102573","article-title":"COVID-19 gone bad: a new character in the spectrum of the hyperferritinemic syndrome?","volume":"19","author":"Colafrancesco\n \nS","year":"2020;"},{"key":"CIT0013","series-title":"Int Immunol","first-page":"401\u20139","article-title":"Hyperferritinemia and inflammation","volume":"29","author":"Kernan\n \nKF","year":"2017;"},{"key":"CIT0014","series-title":"Integr Biol","first-page":"486\u2013510","article-title":"Diagnostic morphology: biophysical indicators for iron-driven inflammatory diseases","volume":"6","author":"Pretorius\n \nE","year":"2014;"},{"key":"CIT0015","series-title":"Int J Infect Dis","first-page":"303\u20135","article-title":"Iron: innocent bystander or vicious culprit in COVID-19 pathogenesis?","volume":"97","author":"Edeas\n \nM","year":"2020;"},{"key":"CIT0016","series-title":"Microsc Res Tech","first-page":"1185\u201390","article-title":"Iron enhances generation of fibrin fibers in human blood: implications for pathogenesis of stroke","volume":"75","author":"Lipinski\n \nB","year":"2012;"},{"issue":"(4)","key":"CIT0017","series-title":"Free Radic Biol Med","first-page":"457\u201363","article-title":"Ferritin, iron homeostasis, and oxidative damage","volume":"33","author":"Arosio\n \nP","year":"2002;"},{"key":"CIT0018","series-title":"Clin Epidemiol Glob Health","first-page":"101295","article-title":"Association of serum ferritin with severity and clinical outcome in COVID-19 patients: an observational study in a tertiary healthcare facility","volume":"21","author":"Kurian\n \nSJ","year":"2023;"},{"issue":"(8)","key":"CIT0019","series-title":"Clin Respir J","first-page":"2378\u201389","article-title":"Prognostic evaluation of serum ferritin in acute exacerbation of idiopathic pulmonary fibrosis","volume":"12","author":"Enomoto\n \nN","year":"2018;"},{"issue":"(4)","key":"CIT0020","series-title":"Am J Physiol Lung Cell Mol Physiol","first-page":"L487\u201399","article-title":"Investigating the role of platelets and platelet-derived transforming growth factor-\u03b2 in idiopathic pulmonary fibrosis","volume":"325","author":"Chong\n \nDL","year":"2023;"},{"issue":"(29-30)","key":"CIT0021","series-title":"Deutsch \u00c4rztebl Int","first-page":"500","article-title":"The pathology of severe COVID-19-related lung damage: mechanistic and therapeutic implications","volume":"117","author":"Kommoss\n \nFK","year":"2020;"},{"issue":"(5)","key":"CIT0022","series-title":"Lancet Respir Med","first-page":"395\u2013401","article-title":"Chronology of histological lesions in acute respiratory distress syndrome with diff use alveolar damage: a prospective cohort study of clinical autopsies","volume":"1","author":"Thille\n \nAW","year":"2013;"},{"issue":"(1)","key":"CIT0023","series-title":"Clin Respir J","first-page":"48\u201356","article-title":"Platelet function in diabetic and nondiabetic patients with chronic obstructive pulmonary disease: a case control study","volume":"12","author":"Makhlouf\n \nHA","year":"2018;"},{"issue":"(2)","key":"CIT0024","series-title":"Diseases","first-page":"22","article-title":"Mean platelet volume as a predictor of COVID-19 severity: a prospective cohort study in the highlands of Peru","volume":"10","author":"Quispe-Pari\n \nJF","year":"2022;"},{"issue":"(1)","key":"CIT0025","series-title":"Hear Lung Circ","first-page":"29\u201334","article-title":"Association between PDW and long term major adverse cardiac events in patients with acute coronary syndrome","volume":"25","author":"Ulucan\n \nS\u00b8","year":"2016;"},{"issue":"(4)","key":"CIT0026","series-title":"Revista Portuguesa de Pneumologia (English Edition)","first-page":"196\u2013201","article-title":"Could \u201cred cell distribution width\u201d predict COPD severity?","volume":"22","author":"Tertemiz\n \nKC","year":"2016;"},{"issue":"(11)","key":"CIT0027","series-title":"Saudi Med J","first-page":"1223\u20138","article-title":"Predictive value of platelet to lymphocyte ratio and neutrophil to lymphocyte ratio in evaluating both lung involvement and severity of patients with coronavirus disease 2019","volume":"42","author":"Aksu\n \nY","year":"2021;"},{"issue":"(10)","key":"CIT0028","series-title":"PLoS One","first-page":"1\u20138","article-title":"Increased platelet reactivity in idiopathic pulmonary fibrosis is mediated by a plasma factor","volume":"9","author":"Crooks\n \nMG","year":"2014;"},{"issue":"(7)","key":"CIT0029","series-title":"Int J Res Stud Med Heal Sci","first-page":"8\u201311","article-title":"Is mean platelet volume useful for predicting the prognosis of COVID-19 diagnosed patients?","volume":"5","author":"Aktas\n \nA","year":"2020;"},{"issue":"(4)","key":"CIT0030","series-title":"Clin Appl 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