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

Karakoyun, İnanç; Çolak, Ayfer; Türken, Melda; Altın, Zeynep; Arslan, Fatma Demet; Iyilikci, Veli; Yılmaz, Nisel; Köse, Şükran

doi:10.1016/j.intimp.2020.107285

Cited by 53 publications

(76 citation statements)

References 30 publications

(25 reference statements)

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“…Metabolic disturbances in the pathway of glycolipid can affect the severity of COVID-19 by creating an imbalance between angiotensin converting enzyme-2, causing a cytokine storm (10). The results of our study are consistent with the literature on this topic.…”

Section: Discussionsupporting

confidence: 91%

“…The primary ones of these defines are, the binging and transport, colloid-osmotic pressure effect, free radical scavenging, anticoagulant effect and increasing capillary membrane permeability (13). However, it can be significantly adversely affected by factors such as inflammation, which can cause a decrease in serum albumin levels by downregulating albumin synthesis through IL-6 and TNF-α or by increasing the catabolism (10). On the other hand, in the literature, there are studies include many desease which hypoalbuninemia is associated with poor outcome (14,15).…”

Section: Discussionmentioning

confidence: 99%

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Predictive value of C-reactive protein/albumin ratio in predicting poor outcome of hospitalized patients with COVID-19

Bahadırlı

Kurt

2021

Journal of Health Sciences and Medicine

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Introduction: For more than a year, COVID-19 has caused a high number of mortality and morbidity, and negatively affects life all over the world. Early detection tools that can be used to predict prognosis are particularly important in patients who need critical care. Among the acute phase reactants, CRP can be higher without any other findings. Otherwise, the cytokine storm that occurs in hospitalized COVID-19 cases can cause critical hypoalbuminemia, and low albumin levels can predict the course of the disease independently of other indicators. Our aim in this study is to determine the relationship between CRP / albumin ratio (CAR) and prognosis of COVID-19 patients. Material and Method:In this study, from February 1, 2021 to April 30, 2021, patients who visited to the emergency department, diagnosed with COVID-19 and hospitalized, were selected to examine retrospectively. Results:The study was completed with total of 273 patients. We divided the patients into two groups as those who require ICU and those who do not. The CAR was found to be more than 2 times higher in the ICU required group than the non-ICU need group (1.43 -0.61, respectively). The area under the curve (AUC) of CRP, albumin and CAR were 0.708, 0.321 and 0.729 for the prediction of ICU admissions, respectively. In terms of mortality, AUC values were calculated as 0.660, 0.304 and 0.725, in the same order, and the predictive power of CAR was higher than CRP and albumin alone in both outcomes. Conclusion:We found that the patients with high CAR values had further ICU requirements and further mortality rates. CAR is a simple, convenient and inexpensive prognostic marker that can be used in predicting the severity of COVID-19.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Predictive value of C-reactive protein/albumin ratio in predicting poor outcome of hospitalized patients with COVID-19

Bahadırlı

Kurt

2021

Journal of Health Sciences and Medicine

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“…However, they have been associated with prognostic value in a wide variety of conditions. 21,22 We found an association of severe infections with some inflammatory markers in the univariate analysis. WBC count, ESR, CRP, albumin, NLR, CRPAR, MPVL and LRINEC score were significantly higher in severe infections but only albumin <2.8 g/dl, ESR >94 mm/h and NLR >4.52 remained significant in the multivariate model.…”

Section: Discussionmentioning

confidence: 72%

Clinical, microbiological and inflammatory markers of severe diabetic foot infections

Aragón‐Sánchez

Víquez-Molina²,

López-Valverde

et al. 2021

Diabet Med

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Classifying diabetic foot infection (DFI) according to its severity is recommended by the International Working Group on Diabetic Foot (IWGDF). 1 Key issues in patient management, such as the need for hospitalization, urgent evaluation by a foot surgeon and the route of antibiotic administration, may depend on the severity of the infection. 1 The classification system also has prognostic value. 2 The severity scheme validated in 2007 presents a significant association with the risk of amputation and a greater number of amputations and readmissions. 2 According to both the Infectious

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“…Inflammation activates production of various acute-phase reactants. One such marker, Creactive protein (CRP) has been linked to severe form of COVID-19 [5,6]. Significant higher levels of severe lactate dehydrogenases (LDH) and ferritin also have been associated with poor prognosis and failure to normalize of the biomarkers was considered as a significant predictor for mortality [7,8].…”

Section: Introductionmentioning

confidence: 99%

Inflammatory and Immune Biomarkers in Predicting the Severity in COVID-19

Prasad

Patel

Behera

et al. 2021

JAMMR

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Aims: An early diagnosis of severity can be confidently judged by monitoring the serum biomarkers in patients with COVID-19. The study was thus aimed to explore the relationship of the inflammatory and immune biomarkers in predicting the severity of the disease. Study design: It is a retrospective observational study. Methodology: The study included 79 confirmed cases of COVID-19 who had complete clinical record for the analytical variables. All cases were assigned a total clinical score as per their clinical manifestations, associated co-morbidities and mortality outcome. Laboratory inflammatory and immune biomarkers at the time of admission were noted. Results: The mean age of the study population was 55.38 (1.69) years. The percentage of admission for males (67.1%) was twice that of females (32.9%). Serum LDH (p=0.003) and ferritin (0.019) levels were remarkably raised in severe form. Total clinical score denoted a positive correlation with the inflammatory biomarkers (p<0.001). IgM exhibited a significant negative trend with increasing clinical score (p<0.001) and CRP levels (p=0.022) of the patients. The multivariate analysis reflected that the total clinical score was significantly influenced by initial SpO2 values (0.011), serum ferritin (0.027), IgM (0.001) and C3 levels (0.044) in the COVID-19 patients. Lower serum C3 values significantly influenced the hospitalization duration in moderate cases (p=0.034) and total clinical score in severe cases (p=0.01). Conclusion: The findings of the study signified that besides serum ferritin, a serial and close monitoring of serum IgM with complement factor C3 would aid in early prediction of clinical severity and thus guide physicians to start effective management strategy.

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

Cited by 53 publications

References 30 publications

Predictive value of C-reactive protein/albumin ratio in predicting poor outcome of hospitalized patients with COVID-19

Predictive value of C-reactive protein/albumin ratio in predicting poor outcome of hospitalized patients with COVID-19

Clinical, microbiological and inflammatory markers of severe diabetic foot infections

Inflammatory and Immune Biomarkers in Predicting the Severity in COVID-19

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