The role of serum inflammatory markers, albumin, and hemoglobin in predicting the diagnosis in patients admitted to the emergency department with a pre-diagnosis of COVID-19

Akman, Canan; Bakırdöğen, Serkan

doi:10.1590/1806-9282.67.suppl1.20200917

Cited by 4 publications

(10 citation statements)

References 19 publications

(26 reference statements)

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“…16,31 In many recent studies, low albumin levels on admission were proposed to be associated with all the other negative outcomes in addition to mortality in patients with severe COVID-19. 10,11,32 Similar to the studies in the literature, in our study, too, low albumin levels were found to be closely associated with mortality (cut-off ≤2.87, 83.2% sensitivity, 88.6% specificity, AUC: 0.914, p<0.001).…”

supporting

confidence: 90%

“…12,15 Furthermore, RAR may contribute to risk classification and early triage in emergency rooms in case of intensive conditions such as the COVID-19 pandemic due to being a rapid and economic parameter that is easily calculated from routine blood analysis. 34 Although the important roles of RDW or albumin have been reported in many studies on patients with COVID-19, 10,24 we could not find a study on the prognostic value of RAR. Therefore, we hope that our study will be supported by other studies on this issue.…”

mentioning

confidence: 84%

“… 9 In many studies, hypoalbuminemia at the time of admission was stated to be related to mortality in COVID-19 patients. 10 , 11 …”

Section: Introductionmentioning

confidence: 99%

“…9 In many studies, hypoalbuminemia at the time of admission was stated to be related to mortality in COVID-19 patients. 10,11 RAR, which is defined as the proportion of RDW to albumin, is a novel and simple inflammatory marker. A strong inflammatory response may lead to a significant increase in RAR.…”

Section: Introductionmentioning

confidence: 99%

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The Relationship Between Prognosis and Red Cell Distribution Width (RDW) and RDW-Albumin Ratio (RAR) in Patients with Severe COVID-19 Disease

Ertekin¹,

Acar²

2022

IJGM

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Purpose The present study aimed to investigate the relationship between prognosis and the red cell distribution width (RDW) and the RDW-albumin ratio (RAR) in patients with coronavirus diseases 2019 (COVID-19), since serum albumin and RDW levels may reflect inflammatory conditions. Patients and Methods A total of 289 patients who had been diagnosed with severe COVID-19 in the emergency department were retrospectively analyzed. The RAR levels were calculated by dividing RDW-CV by albumin. Patient groups (survivors, dying patients, those who received mechanical ventilation (MV) support or not, and those who needed vasopressors or not) were compared with regard to RDW-SD, RDW-CV and the RAR levels. Results RDW-SD, RDW-CV and the RAR levels were found to be statistically significantly higher in patients who died, and who received MV and vasopressor support, compared to those who survived and did not receive support (p<0.001 for all). In addition, while the cut-off value of RAR was >5.43, the sensitivity was 91.6%, the specificity was 93.7%, NPV was 93.1% and the AUC was 0.965 in predicting mortality (p<0.001). Logistic regression analysis showed that RDW-SD and RAR were independent risk factors for mortality in patients with severe COVID-19. Conclusion Elevated RDW and RAR levels at the time of admission may independently predict mortality and the need for vasopressor or MV support.

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supporting

confidence: 90%

mentioning

confidence: 84%

“… 9 In many studies, hypoalbuminemia at the time of admission was stated to be related to mortality in COVID-19 patients. 10 , 11 …”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Relationship Between Prognosis and Red Cell Distribution Width (RDW) and RDW-Albumin Ratio (RAR) in Patients with Severe COVID-19 Disease

Ertekin¹,

Acar²

2022

IJGM

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“…A significant difference in mean ferritin levels of 606.37 ng/mL (95% CI 461.86; 750.88) was found between survivors and non-survivors, but not in hemoglobin levels ( 30 ). Similarly, low levels of hemoglobin have been recently shown to be predictive factors for the diagnosis and prediction of patients with COVID-19 ( 17 , 18 ). Hemoglobin levels have also shown to predict the severity of COVID-19, with a gradual decrease with disease progression ( 19 ).…”

Section: Discussionmentioning

confidence: 93%

Blood Hemoglobin Substantially Modulates the Impact of Gender, Morbid Obesity, and Hyperglycemia on COVID-19 Death Risk: A Multicenter Study in Italy and Spain

et al. 2021

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BackgroundHyperglycemia and obesity are associated with a worse prognosis in subjects with COVID-19 independently. Their interaction as well as the potential modulating effects of additional confounding factors is poorly known. Therefore, we aimed to identify and evaluate confounding factors affecting the prognostic value of obesity and hyperglycemia in relation to mortality and admission to the intensive care unit (ICU) due to COVID-19.MethodsConsecutive patients admitted in two Hospitals from Italy (Bologna and Rome) and three from Spain (Barcelona and Girona) as well as subjects from Primary Health Care centers. Mortality from COVID-19 and risk for ICU admission were evaluated using logistic regression analyses and machine learning (ML) algorithms.ResultsAs expected, among 3,065 consecutive patients, both obesity and hyperglycemia were independent predictors of ICU admission. A ML variable selection strategy confirmed these results and identified hyperglycemia, blood hemoglobin and serum bilirubin associated with increased mortality risk. In subjects with blood hemoglobin levels above the median, hyperglycemic and morbidly obese subjects had increased mortality risk than normoglycemic individuals or non-obese subjects. However, no differences were observed among individuals with hemoglobin levels below the median. This was particularly evident in men: those with severe hyperglycemia and hemoglobin concentrations above the median had 30 times increased mortality risk compared with men without hyperglycemia. Importantly, the protective effect of female sex was lost in subjects with increased hemoglobin levels.ConclusionsBlood hemoglobin substantially modulates the influence of hyperglycemia on increased mortality risk in patients with COVID-19. Monitoring hemoglobin concentrations seem of utmost importance in the clinical settings to help clinicians in the identification of patients at increased death risk.

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Scrutinizing Clinical Biomarkers in a Large Cohort of Patients with Lyme Disease and Other Tick-Borne Infections

Xi,

Garg,

Lambert

et al. 2024

Microorganisms

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Standard clinical markers can improve tick-borne infection (TBI) diagnoses. We investigated immune and other clinical biomarkers in 110 patients clinically diagnosed with TBIs before (T0) and after antibiotic treatment (T2). At T0, both the initial observation group and patients without seroconversion for tick-borne pathogens exhibited notably low percentages and counts of CD3 percentage (CD3%), CD3+ cells, CD8+ suppressors, CD4 percentage (CD4%), and CD4+ helper cells, with the latter group showing reductions in CD3%, CD3+, and CD8+ counts in approximately 15-22% of cases. Following treatment at the T2 follow-up, patients typically experienced enhancements in their previously low CD3%, CD3+ counts, CD4%, and CD4+ counts; however, there was no notable progress in their low CD8+ counts, and a higher number of patients presented with insufficient transferrin levels. Moreover, among those with negative serology for tick-borne infections, there was an improvement in low CD3% and CD3+ counts, which was more pronounced in patients with deficient transferrin amounts. Among those with CD57+ (n = 37) and CD19+ (n = 101) lymphocyte analysis, 59.46% of patients had a low CD57+ count, 14.85% had a low CD19 count, and 36.63% had a low CD19 percentage (CD19%). Similar findings were observed concerning low CD57+, CD19+, and CD19% markers for negative TBI serology patients. Overall, this study demonstrates that routine standard clinical markers could assist in a TBI diagnosis.

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The role of serum inflammatory markers, albumin, and hemoglobin in predicting the diagnosis in patients admitted to the emergency department with a pre-diagnosis of COVID-19

Cited by 4 publications

References 19 publications

The Relationship Between Prognosis and Red Cell Distribution Width (RDW) and RDW-Albumin Ratio (RAR) in Patients with Severe COVID-19 Disease

The Relationship Between Prognosis and Red Cell Distribution Width (RDW) and RDW-Albumin Ratio (RAR) in Patients with Severe COVID-19 Disease

Blood Hemoglobin Substantially Modulates the Impact of Gender, Morbid Obesity, and Hyperglycemia on COVID-19 Death Risk: A Multicenter Study in Italy and Spain

Scrutinizing Clinical Biomarkers in a Large Cohort of Patients with Lyme Disease and Other Tick-Borne Infections

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