Prognostic value of ANDC score and CRP-derived inflammatory markers in hospitalized adult patients with COVID-19

Abstract

Background:SARS-CoV-2 has been a causative agent of severe acute respiratory syndrome since last 2019. Early diagnosis of severe cases is crucial to decrease a patient's hospital stay and death risk. severity and prognosis Patients and Methods:This retrospective study included COVID-19 patient underwent chest computed tomography scan and a battery of laboratory tests, including measurements of leukocytes, neutrophils, lymphocytes, lactic dehydrogenase, creatinine level, ferritin, D-dimer, albumin, and C-reactive protein. In addition, the CRP to lymphocyte ratio (CLR), CRP to albumin ratio (CAR), CRP to platelet ratio (CPR) and the ANDC score. Patients' clinical outcomes including length of hospital stays (LOS) and mortality were recorded. Results:Out of 98 patients, 51 patients had passed away. There was a statistically significant difference between survivors and non-survivors regarding age, TLC, ANC, NLR, D-Dimer, and albumin. Moreover, a highly statistically significant difference regarding CRP levels, CAR, CPR, CLR, and ANDC was noted. Serum CRP level > 123 ng/ml, CAR > 36.77, CPR level > 462, and CLR > 84 had sensitivity; (64.71 %, 66.6 %, 72.5 %, and 76.4 %, respectively) and specificity; (85.1 %, 78.7 %, 72.3 %, and 72.3 % respectively) in mortality prediction. Meanwhile, the ANDC score was the most sensitive indicator (88.2 %) for mortality outcome. Multivariable regression analysis revealed that aging, CPR, and ANDC level were independently associated with mortality with H.R. [1.025 (1.002–1.050); 2.338 (1.189–4.599) and 2.896 (1.191–7.044)] Conclusion:The value of the ANDC score and CRP-derived inflammatory indicators correlate with the likelihood of mortality, so the efficacy of these metrics might assist in urgent early dialogues about treatment escalation.