Abstract
References
- Ak R, Kurt E, Bahadirli S. The comparison of two risk prediction models specific for COVID-19: The Brescia-COVID Respiratory Severity Scale versus the Quick COVID-19 Severity Index. Disaster Med Public Health Prep 2021; 1–17.
- Seyhan AU, Doganay F, Yilmaz E, Topal NP, Ak R. Investigation of QT Prolongation with Hydroxychloroquine and Azithromycin for the Treatment of COVID-19. Journal of the College of Physicians and Surgeons--pakistan: JCPSP 2020; 30: 153-7.
- Felger JC, Haroon E, Patel TA, et al. What does plasma CRP tell us about peripheral and central inflammation in depression? Molecular psyc 2020; 25: 1301-11.
- Tan C, Huang Y, Shi F, et al. C-reactive protein correlates with computed tomographic findings and predicts severe COVID-19 early. J Med Virol 2020; 92: 856–62.
- Aziz M, Fatima R, Lee-Smith W, Assaly R. The association of low serum albumin level with severe COVID-19: a systematic review and meta-analysis. Crit Care 2020; 24: 255.
- Park JE, Chung KS, Song JH, et al. The C-Reactive Protein/Albumin Ratio as a Predictor of Mortality in Critically Ill Patients. J Clin Med 2018; 7: 333.
- Feketea GM, Vlacha V. The Diagnostic Significance of Usual Biochemical Parameters in Coronavirus Disease 19 (COVID-19): Albumin to Globulin Ratio and CRP to Albumin Ratio. Front Med 2020; 7.
- Amawi H, Abu Deiab GI, A Aljabali AA, Dua K, Tambuwala MM. COVID-19 pandemic: an overview of epidemiology, pathogenesis, diagnostics and potential vaccines and therapeutics. Ther Deliv 2020; 11: 245–68.
- Chen W, Zheng KI, Liu S, Yan Z, Xu C, Qiao Z. Plasma CRP level is positively associated with the severity of COVID-19. Ann Clin Microbiol Antimicrob 2020; 19: 1–7.
- Karakoyun I, Colak A, Turken M, et al. Diagnostic utility of C-reactive protein to albumin ratio as an early warning sign in hospitalized severe COVID-19 patients. Int Immunopharmacol 2021; 91: 107285.
- Sproston NR, Ashworth JJ. Role of C-reactive protein at sites of inflammation and infection. Front Immunol 2018; 9: 754.
- Liu F, Li L, Xu M, et al. Prognostic value of interleukin-6, C-reactive protein, and procalcitonin in patients with COVID-19. J Clin Virol 2020; 104370.
- Margarson MP, Soni N. Serum albumin: touchstone or totem? Anaesthesia 1998; 53: 789–803.
- Hannan JL, Radwany SM, Albanese T. In-Hospital Mortality in Patients Older Than 60 Years with Very Low Albumin Levels. J Pain Symptom Manage 2012; 43: 631–7.
- Gibson DJ, Hartery K, Doherty J, et al. CRP/Albumin Ratio. J Clin Gastroenterol 2018; 52: e48–52.
- Fairclough E, Cairns E, Hamilton J, Kelly C. Evaluation of a modified early warning system for acute medical admissions and comparison with C-reactive protein/albumin ratio as a predictor of patient outcome. Clin Med Lond Engl 2009; 9: 30–3.
- Luo B, Sun M, Huo X, Wang Y. Two new inflammatory markers related to the CURB-65 score for disease severity in patients with community-acquired pneumonia: The hypersensitive C-reactive protein to albumin ratio and fibrinogen to albumin ratio. Open Life Sci 2021; 16: 84–91.
- Liu Y, Chen S, Zheng C, et al. The prognostic value of the preoperative c-reactive protein/albumin ratio in ovarian cancer. BMC Cancer 2017; 17: 285.
- Deniz CD. Analayzing diagnostic value of c-reactive protein/albumin ratio with roc curve in novel coronavirus disease-19(COVİD-19).Curr Res New Trends: 2020; 18.
- Wang X, Xu Y, Huang H, et al. An increased pretreatment C-reactive protein-to-albumin ratio predicts severe novel coronavirus-infected pneumonia. Research Square; 2020. DOI: 10.21203/rs.3.rs-31723/v1.
- Saylik F, Akbulut T, Kaya S. Can C-Reactive Protein to Albumin Ratio Predict In-Hospital Death Rate Due to COVID-19 in Patients With Hypertension? Angiology 2021; : 00033197211012145.
Predictive value of C-reactive protein/albumin ratio in predicting poor outcome of hospitalized patients with COVID-19
Abstract
Introduction
For more than a year, COVID-19 has caused a high number of mortality and morbidity, and negatively affects life all over the world. Early detection tools that can be used to predict prognosis are particularly important in patients who need critical care. Among the acute phase reactants, CRP can be higher without any other findings. Otherwise, the cytokine storm that occurs in hospitalized COVID-19 cases can cause critical hypoalbuminemia, and low albumin levels can predict the course of the disease independently of other indicators. Our aim in this study is to determine the relationship between CRP / albumin ratio (CAR) and prognosis of COVID-19 patients.
Material and Method
In this study, from February 1, 2021 to April 30, 2021, patients who visited to the emergency department, diagnosed with COVID-19 and hospitalized, were selected to examine retrospectively.
Results
The study was completed with total of 273 patients. We divided the patients into two groups as those who require ICU and those who do not. The CAR was found to be more than 2 times higher in the ICU required group than the non-ICU need group (1.43 - 0.61, respectively). The area under the curve (AUC) of CRP, albumin and CAR were 0.708, 0.321 and 0.729 for the prediction of ICU admissions, respectively. In terms of mortality, AUC values were calculated as 0.660, 0.304 and 0.725, in the same order, and the predictive power of CAR was higher than CRP and albumin alone in both outcomes.
Conclusion
We found that the patients with high CAR values had further ICU requirements and further mortality rates. CAR is a simple, convenient and inexpensive prognostic marker that can be used in predicting the severity of COVID-19.
Keywords
References
- Ak R, Kurt E, Bahadirli S. The comparison of two risk prediction models specific for COVID-19: The Brescia-COVID Respiratory Severity Scale versus the Quick COVID-19 Severity Index. Disaster Med Public Health Prep 2021; 1–17.
- Seyhan AU, Doganay F, Yilmaz E, Topal NP, Ak R. Investigation of QT Prolongation with Hydroxychloroquine and Azithromycin for the Treatment of COVID-19. Journal of the College of Physicians and Surgeons--pakistan: JCPSP 2020; 30: 153-7.
- Felger JC, Haroon E, Patel TA, et al. What does plasma CRP tell us about peripheral and central inflammation in depression? Molecular psyc 2020; 25: 1301-11.
- Tan C, Huang Y, Shi F, et al. C-reactive protein correlates with computed tomographic findings and predicts severe COVID-19 early. J Med Virol 2020; 92: 856–62.
- Aziz M, Fatima R, Lee-Smith W, Assaly R. The association of low serum albumin level with severe COVID-19: a systematic review and meta-analysis. Crit Care 2020; 24: 255.
- Park JE, Chung KS, Song JH, et al. The C-Reactive Protein/Albumin Ratio as a Predictor of Mortality in Critically Ill Patients. J Clin Med 2018; 7: 333.
- Feketea GM, Vlacha V. The Diagnostic Significance of Usual Biochemical Parameters in Coronavirus Disease 19 (COVID-19): Albumin to Globulin Ratio and CRP to Albumin Ratio. Front Med 2020; 7.
- Amawi H, Abu Deiab GI, A Aljabali AA, Dua K, Tambuwala MM. COVID-19 pandemic: an overview of epidemiology, pathogenesis, diagnostics and potential vaccines and therapeutics. Ther Deliv 2020; 11: 245–68.
- Chen W, Zheng KI, Liu S, Yan Z, Xu C, Qiao Z. Plasma CRP level is positively associated with the severity of COVID-19. Ann Clin Microbiol Antimicrob 2020; 19: 1–7.
- Karakoyun I, Colak A, Turken M, et al. Diagnostic utility of C-reactive protein to albumin ratio as an early warning sign in hospitalized severe COVID-19 patients. Int Immunopharmacol 2021; 91: 107285.
- Sproston NR, Ashworth JJ. Role of C-reactive protein at sites of inflammation and infection. Front Immunol 2018; 9: 754.
- Liu F, Li L, Xu M, et al. Prognostic value of interleukin-6, C-reactive protein, and procalcitonin in patients with COVID-19. J Clin Virol 2020; 104370.
- Margarson MP, Soni N. Serum albumin: touchstone or totem? Anaesthesia 1998; 53: 789–803.
- Hannan JL, Radwany SM, Albanese T. In-Hospital Mortality in Patients Older Than 60 Years with Very Low Albumin Levels. J Pain Symptom Manage 2012; 43: 631–7.
- Gibson DJ, Hartery K, Doherty J, et al. CRP/Albumin Ratio. J Clin Gastroenterol 2018; 52: e48–52.
- Fairclough E, Cairns E, Hamilton J, Kelly C. Evaluation of a modified early warning system for acute medical admissions and comparison with C-reactive protein/albumin ratio as a predictor of patient outcome. Clin Med Lond Engl 2009; 9: 30–3.
- Luo B, Sun M, Huo X, Wang Y. Two new inflammatory markers related to the CURB-65 score for disease severity in patients with community-acquired pneumonia: The hypersensitive C-reactive protein to albumin ratio and fibrinogen to albumin ratio. Open Life Sci 2021; 16: 84–91.
- Liu Y, Chen S, Zheng C, et al. The prognostic value of the preoperative c-reactive protein/albumin ratio in ovarian cancer. BMC Cancer 2017; 17: 285.
- Deniz CD. Analayzing diagnostic value of c-reactive protein/albumin ratio with roc curve in novel coronavirus disease-19(COVİD-19).Curr Res New Trends: 2020; 18.
- Wang X, Xu Y, Huang H, et al. An increased pretreatment C-reactive protein-to-albumin ratio predicts severe novel coronavirus-infected pneumonia. Research Square; 2020. DOI: 10.21203/rs.3.rs-31723/v1.
- Saylik F, Akbulut T, Kaya S. Can C-Reactive Protein to Albumin Ratio Predict In-Hospital Death Rate Due to COVID-19 in Patients With Hypertension? Angiology 2021; : 00033197211012145.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Original Article |
| Authors | |
| Publication Date | July 15, 2021 |
| Published in Issue | Year 2021 Volume: 4 Issue: 4 |
Cited By
CRP/Albumin Ratio and NLR in Recognizing Critically Ill Patients
Eurasian Journal of Critical Care
https://doi.org/10.55994/ejcc.1435162
The effect of CRP/albumin ratio on prognosis of hospitalized patients due to COVID-19
Family Practice and Palliative Care
https://doi.org/10.22391/fppc.1132063
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