Diagnostic utility of C-reactive protein to albumin ratio as an early warning sign in hospitalized severe COVID-19 patients

Karakoyun I., Colak A., Turken M., Altin Z., Arslan F. D., Iyilikci V., ...Daha Fazla

INTERNATIONAL IMMUNOPHARMACOLOGY, cilt.91, 2021 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 91
  • Basım Tarihi: 2021
  • Doi Numarası: 10.1016/j.intimp.2020.107285
  • Dergi Adı: INTERNATIONAL IMMUNOPHARMACOLOGY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, Biotechnology Research Abstracts, CAB Abstracts, Chemical Abstracts Core, EMBASE, MEDLINE, Veterinary Science Database
  • Anahtar Kelimeler: C-reactive protein to albumin ratio, SARS-CoV-2, COVID-19, PROTEIN/ALBUMIN RATIO, INFLAMMATION, CRP
  • Dokuz Eylül Üniversitesi Adresli: Hayır

Özet

C-reactive protein-to-albumin ratio (CAR) has been used as an indicator of prognosis in various diseases. Here, we intended to assess the CAR's diagnostic power in early differentiation of hospitalized severe COVID-19 cases. In this retrospectively designed study, we evaluated 197 patients in total. They were divided into two groups based on their severity of COVID-19 as non-severe (n = 113) and severe (n = 84). The comparison of groups' demographic data, comorbidities, clinical symptoms, and laboratory test results were done. Laboratory data of the patients within the first 24 h after admission to the hospital were evaluated. The calculation of receiver operating characteristic (ROC) curve was used to determine the diagnostic power of CAR in differentiating severity of COVID-19. Independent risk factors predictive of COVID-19 severity were determined by using logistic regression analysis. Although lymphocyte count levels were lower, severe COVID-19 patients had higher mean age, higher levels of neutrophil count, CRP, aspartate aminotransferase (AST), ferritin, and prothrombin time (P < 0.05). Compared with non-severe patients (median, 0.23 [IQR = 0.07-1.56]), patients with severe COVID-19 had higher CAR levels (median, 1.66 [IQR = 0.50-3.35]; P < 0.001). Age (OR = 1.046, P = 0.003), CAR (OR =1.264, P = 0.037), and AST (OR = 1.029, P = 0.037) were independent risk factors for severe COVID19 based on the multivariate logistic regression analysis. ROC curve analysis assigned 0.9 as the cut-off value for CAR for differentiation of severe COVID-19 (area under the curve = 0.718, 69.1% sensitivity, 70.8% specificity, P < 0.001). CAR is a useful marker in early differentiation of severity in patients hospitalized due to COVID-19 that have longer hospital stay and higher mortality.