An investigation of salivary ferritin levels in COVID-19 patients; a case-control study

Background: The global impact of COVID-19 necessitates effective methods to assess disease severity, prompting the exploration of salivary ferritin as a potential biomarker due to its roles in iron storage and immune modulation. Methods: A case-control study comprising 60 participants (30 COVID-19 patients and 30 controls) was conducted. Salivary samples were collected using a non-stimulatory draining technique and analyzed using an enzyme-linked immunosorbent assay (ELISA) for ferritin quantification. The SOFA score, reflecting disease severity, was recorded for the case group. Statistical analyses, including Mann-Whitney tests and partial correlation controlling for age and sex, were performed to assess relationships between salivary ferritin, SOFA score, and demographic variables. Results: The mean age was 54.1 ± 18.5 years in the case group and 33.8 ± 10.0 years in the control group. Of the participants, 48% were female and 52% were male. The case group had a non-significantly higher mean rank of salivary ferritin (31.30) compared to the control group (29.70) (U = 426.000, p = .723). No significant differences were observed in ferritin levels between COVID-19 patients and controls (p = 0.88). However, a significant correlation emerged between salivary ferritin levels and SOFA score (p < .001), indicating a potential link between ferritin concentrations and disease severity. Conclusions: Results show a non-significantly higher mean rank of salivary ferritin in COVID-19 patients. The observed correlation between salivary ferritin and SOFA score suggests its potential as a non-invasive biomarker for assessing disease severity, contributing to understanding COVID-19 pathophysiology. Further research is needed to validate its role in diverse patient populations.