Abstract
Purpose: This study aims to assess the diagnostic utility of C-reactive protein (CRP) to albumin ratio (CAR) for predicting elevated D-dimer levels in COVID-19.
 Materials and Methods: This retrospective cohort study collected data from 145 hospitalized patients with confirmed COVID-19 in a university hospital. Patients were divided into two groups based on their D-dimer levels, as elevated D‐dimer levels and normal D-dimer levels. Demographic data, comorbidities, clinical symptoms, CAR, and laboratory results were obtained from the patients’ medical records and compared between the groups.
 Results: The mean age of patients was 52.9±17.9 years, and 76 of them were male. The median of CAR was significantly higher in those with higher D-dimer (134.1 vs. 20.7). CRP, procalcitonin, leukocyte, neutrophil, lactate dehydrogenase, ferritin, and fibrinogen were higher in patients with elevated D-dimer levels. There was a highly significant positive correlation between CAR and D-Dimer. Logistic regression analysis revealed that CAR was a significant determinant for elevated D‐dimer levels . The area under the ROC curve (AUC) was 0.741 for CAR. The verified cut-off value of CAR for predicting elevated D‐dimer levels in patients with COVID-19 was 81.8, with a sensitivity of 58% and a specificity of 70%. 
 Conclusion: Our study revealed that CAR was significantly correlated with D-dimer and can be used to predict elevated D‐dimer levels in patients with COVID-19.
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