COVID-19'un uzun dönem mortalitesinde C-reaktif protein/ albümin oranı ve sistemik immün inflamasyon indeksinin prediktif değeri

Abstract

Amaç: Coronavirüs-19 hastalığının (COVID-19) kısa dönem prognozu ile biyobelirteçlerle ilgili bir çok çalışma yapılmıştır; ancak uzun dönem prognozu ile ilgili çalışmalar kısıtlıdır. Amacımız; sistemik inflamasyon indeksi (SII) ve C-reaktif protein/ albümin oranının (CAR) COVID-19 hastalığının hastane içi ve 1 yıllık takiplerinde prediktif değerini saptamaktır. Gereç ve Yöntemler: Primer sonuçlar hastane içi mortalite ve 1 yıllık mortalite idi. İkincil sonuçlar; yatışta yoğun bakım ünitesi (YBÜ) ihtiyacı ve sonrasında YBÜ'ye transfer olma durumu idi. Bulgular: Çalışmaya 449 (53.6 %) erkek ve 389 ( 46.4 %) kadın katıldı. Yaş ortalaması 53.8±18.5 idi. Önceden bilinen kalp yetmezliği (KY), COVID-19 ile ilişkili KY, akut böbrek yetmezliği (ABY), diyabetes mellitus (DM), hipertansiyon (HT), koroner arter hastalığı (KAH), kronik obstrüktif akciğer hastalığı (KOAH)/astım , yüksek CO-RADS skoru ( >4), düşük Ejeksiyon Fraksiyonu (EF), yüksek CAR ve SII, artmış hastane içi ve 1 yıllık mortalite ile ilişkilendirildi (p < 0.05). Çok değişkenli analiz sonucunda; CAR, SII, ABY ve DM hastane içi ve 1 yıllık mortalitenin bağımsız belirteçleri iken, KAH sadece 1 yıllık mortalitenin bağımsız bir öngörücüsüydü. ROC analizi ile sırasıyla 2.54 ve 2.23 CAR değerleri, hastane içi ve 1 yıllık mortaliteyi predikte etti (p <0.001). Sırasıyla 1274 ve 1191 SII değerleri, hastane içi ve 1 yıllık mortaliteyi predikte etti (p <0.001). Sonuç: CAR ve SII, COVID-19’da hem kısa dönemde hem uzun dönemde mortaliteyi tahmin etmek için değerli prognostik indeksler olarak kullanılabilir.

Keywords

• Sistemik İmmün İnflamasyon İndeksi
• SII
• C-reaktif protein/albümin oranı
• CAR
• Uzun dönem mortalite
• COVID-19

Predictive value of c-reactive protein to albumin ratio and systemic immune-inflammation index for the long-term mortality in COVID-19

Abstract

Aim: Several studies have investigated the association between biomarkers and short-term prognosis in the coronavirus infectious disease 2019 (COVID-19). However, data on the long-term prognosis are limited. To determine the predictive value of systemic immune-inflammation index (SII) and C-reactive protein (CRP) to albumin ratio (CAR) for in-hospital and 1-year outcomes during COVID-19. Material and Method: The primary outcomes were in-hospital and 1-year mortality. The secondary outcomes were the intensive care unit (ICU) need at admission and transfer to the ICU later on. Results: The study included 449 (53.6%) males and 389 (46.4%) females with a mean age of 53.8±18.5 years. Previously known heart failure (HF), COVID-19-related HF, acute renal failure (ARF), diabetes mellitus, hypertension, coronary artery disease (CAD), chronic obstructive pulmonary disease (COPD)/asthma, high CO-RADS scores (>4), low ejection fraction (EF), higher CAR and SII were associated with an increased in-hospital and 1-year mortality (p<0.05). After multivariate analysis; CAR, SII, ARF, and diabetes mellitus were independent predictors of in-hospital and 1-year mortality,whereas CAD was only an independent predictor of 1-year mortality. After ROC analysis, CAR cut-off levels of 2.54 and 2.23 predicted in-hospital and 1-year mortality, respectively (p<0.001). The SII cut-off levels of 1274 and 1191 predicted in-hospital and 1-year mortality, respectively (p<0.001). Conclusion: CAR and SII can be used as valuable prognostic indexes to predict both the short-term and long-term mortality in COVID-19.

Keywords

• Systemic immune-inflammation index
• SII
• C-reactive protein to albumin ratio
• CAR
• long-term mortality
• COVID-19

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