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

• C-reactive protein
• albümin
• COVID-19
• intensive care

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