Predictive Role of C-Reactive Protein/Albumin Ratio in Patients with Critical COVID-19 Patients

Abstract

Background: Despite important advances in the management of COVID-19 patients, markers that can predict its severity and guide its treatment are needed. This study aimed to evaluate the relation of C-reactive protein/albumin ratio (CRP/Alb) with the disease severity and its role in prediction of the need for intensive care. Material and Methods: Clinical findings, laboratory results and chest tomography of the COVID-19 patients followed in our hospital between January and June 2021 were retrospectively reviewed. A hundred and thirty-one COVID-19 patients and 81 age- and gender-matched healthy individuals were included in the study. Data about CRP and albumin levels and CRP/Alb was analyzed and obtained findings were compared between COVID-19 patients and healthy individuals. Results: COVID-19 patients and healthy controls were similar in terms of the mean age and gender distribution (p= 0.1 and p= 0.31 respectively). CRP/Alb was significantly higher in the patients than in the controls (p< 0.009). When the patients were classified into critical and non-critical groups based on their clinical status, the critical group was significantly older (p< 0.001) and had a significantly higher CRP/Alb (p<0.001). According to ROC curve analysis, CRP/Alb was predictive of critical clinical picture based on the cut-off value of 14.7 mg/dl, sensitivity of 89% and specifity of 91%. Conclusion: CRP/Alb is practical, inexpensive and easily available and can be used routinely. This study showed that CRP/Alb is a potential parameter that can be utilized to identify patients with critical COVID-19.

Keywords

• COVID-19
• C-reactive protein
• prediction

Kritik COVID-19 Hastalarında C-Reaktif Protein/Albumin Oranının Prediktif Rolü

Abstract

Amaç: COVID-19 hastalarının yönetimindeki önemli gelişmelere rağmen, tedaviyi yönlendirecek, hastalık şid-detini öngören belirteçlere ihtiyaç vardır. Biz de bu çalışmada; C-reaktif protein/Albumin (CRP/Alb) oranının hastalık şiddeti ile ilişkisini ve yoğun bakım ihtiyacını tahmin etmedeki rolünü değerlendirmeyi amaçladık.
Materyal ve metod: Ocak 2021 ile Haziran 2021 tarihleri arasında hastanemizde COVID-19 enfeksiyonu nede-niyle takip edilen hastaların klinik bulguları, laboratuar sonuçları ve akciğer bilgisayarlı tomografisi retrospektif olarak incelendi. Toplam 131 hasta ve benzer yaş ve cinsiyetteki 81 sağlıklı kontrol grubu çalışmaya dahil edildi. CRP, albumin ve CRP/Alb oranı verileri analiz edildi ve COVID-19 hastaları ile sağlıklı kontrol grubu arasında kar-şılaştırıldı.
Bulgular: COVID-19 hastaları ile sağlıklı kontrol grubunun yaş ortalaması ve cinsiyet dağılımı benzerdi (sırası ile p= 0.1 p= 0.31). COVID-19 hastalarının CRP/Alb oranı kontrol grubuna göre anlamlı yüksekti (p< 0.009). COVID-19 hastaları klinik durumlarına göre kritik ve non-kritik olarak sınıflandırıldığında; kritik hastalar non-kritik has-talara göre daha yaşlı (p< 0.001) ve CRP/Alb oranı daha yüksekti (p<0.001). Yapılan ROC analizinde CRP/Alb oranı cut-off 14.7 mg/dl alındığında 89% duyarlılıkla ve 91% özgüllük ile COVID-19 kritik klinik durumu predikte etti.
Sonuç: Sonuç olarak, CRP/Alb oranı, rutin olarak kullanılabilecek pratik, ucuz ve kolay erişilebilir bir testdir. Ça-lışmamızda; CRP/Alb oranı yoğun bakım ihtiyacı olan kritik COVID-19 hastalarını ayırt etmede potansiyel bir pa-rametre olarak tespit edilmiştir.
Anahtar Kelimeler: COVID-19, C-reaktif protein/Albumin, Prediktif

Keywords

• COVID-19
• C-reaktif protein/Albumin
• prediktif

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