Abstract
Objective This study aimed to determine the ability of the C-reactive protein (CRP)-to-albumin ratio (CAR) to predict short-term mortality in patients with COVID-19. Material and methods This retrospective, observational, cohort study included patients with COVID-19. The patients’ demographics, clinical characteristics, CRP, albumin, CAR, blood urea nitrogen, creatinine, Troponin I and all-cause mortality within 30 days after admission were noted. The receiver operating characteristic curve analysis was performed, and odds ratios were calculated to determine the discriminative ability of the parameters. Results A total of 103 patients with a median of age of 57 (20-92) years were included in the study. The rate of 30-day mortality was 4.8% for the study cohort. According to the best Youden’s index, the cut-off value for CRP was determined as 7 (sensitivity: 80%, specificity: 78.6%), and the area under curve (AUC) value was 0.801 (95% confidence interval: 71.1-87.3). According to the best Youden’s index, the cut-off value for CAR was 0.18 (sensitivity: 80%, specificity: 78.6%), and the area under curve (AUC) value was 0.806 (95% confidence interval: 71.6-87.7). There was no statistically significant difference between the AUC values of CRP and CAR (DeLong equality test, p = 0.938). The odds ratios of CRP (>7 mg/L) and CAR (>0.18) for 30-day mortality were 14.667 (95% confidence interval: 1.555-138.299) and 13.818 (95% confidence interval: 1.468-130.076), respectively. Conclusion CAR was not useful in predicting 30-day mortality in patients with COVID-19. The calculation of CAR rather than CRP had no clinically significant contribution to the prediction of 30-day mortality in this patient group.
Highlights
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a respiratory RNA virus that causes severe acute respiratory failure emerged as an epidemic in Wuhan, China at the end of 2019 [1]
It has been shown that an increase in inflammatory markers, such as C-reactive protein (CRP), interleukin-6, leucocyte count, and erythrocyte sedimentation rate can Journal of Clinical Medicine of Kazakhstan: 2021 Volume 18, Issue 6 be a marker of critical illness and mortality [3,4,6]
We examined the ability of CRP-to-albumin ratio (CAR) to predict short-term mortality in patient with COVID-19 presenting to emergency department (ED)
Summary
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a respiratory RNA virus that causes severe acute respiratory failure emerged as an epidemic in Wuhan, China at the end of 2019 [1] It turned into a pandemic, spreading across the world and negatively affecting social lives, economies, and health systems of countries [2]. Acute-phase proteins (APPs) are proteins whose levels fluctuate in response to tissue injury, for example, trauma, acute infection, chronic inflammation, myocardial infarction, and malignancy. Their concentrations increase (positive APPs) or decrease (negative APPs) in response to the acute-phase reaction [8]. Based on the results reported in the literature, we considered that a ratio with a positive
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