Interleukin-6 and C-reactive protein/albumin ratio as predictors of COVID-19 severity and mortality

El-Shabrawy, Mohamed; Alsadik, Maha E.; El-Shafei, Maher; Abdelmoaty, Ahmed; Alazzouni, Ahmed S.; Esawy, Marwa M.; Shabana, Marwa A.

doi:10.1186/s43168-021-00054-1

Cited by 51 publications

(59 citation statements)

References 30 publications

(28 reference statements)

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“…Hence, based on our findings CRP/Albumin ratio can be used as a predictor of disease severity, but not mortality in COVID-19 patients. Our study significantly adds to the emerging scant literature on CRP/Alb ratio and its utility in patients with SARS-CoV-2 infection, to our knowledge there only few studies and their results do not necessarily corroborate with our findings [21,22,23]. This could be secondary to varying methods in differentiating disease severity, ethnicity, population differences and most importantly small sample sizes.…”

Section: Discussioncontrasting

confidence: 70%

Does C reactive protein/Albumin ratio have prognostic value in patients with COVID-19

Kalabin

Mani

Valdivieso

et al. 2021

J Infect Dev Ctries

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Introduction: There is paucity of data regarding C reactive protein/Albumin (CRP/Alb) ratio in patients with SARS-CoV-2 infection. We aimed to evaluate the significance of CRP/Alb ratio in COVID-19 patients. Methodology: Patients hospitalized between March – April 2020 with COVID-19, who had CRP and Albumin levels documented within 24 hours from admission were retrospectively analyzed. Unpaired Student’s t-test was used for continuous and Pearson Chi-square (χ²) test for categorical variables. Univariate and multivariate logistic regression models were developed to assess the relationship between CRP/Alb and mortality. Nonparametric correlations were calculated using Spearman’s Rho correlation coefficient. Results: 75 patients were included. Mean age was 62.92, 26 females (34.67%) and 49 males (65.33%), mean Body Mass Index (BMI) 29.86, mean body temperature 101.3 and mean length of stay (LOS) was 14.80 days. 24 (32%) patients required invasive mechanical ventilation and 51 (68%) did not, mean CRP/Alb ratio was 6.89 and 4.7 respectively (p = 0.036). 15 (20%) patients died, 60 (80%) survived and the mean CRP/Alb difference between these groups was also statistically significant (7.74 vs 4.83, p = 0.02). LOS (OR 0.71, 95% CI 0.57.-0.88, p < 0.001) and BUN (OR 1.04, 95% CI 1.01.-1.07, p = 0.006) were independent predictors of mortality by multivariate logistic regression, whereas CRP/Alb (OR 1.21, 95% CI 0.96.-1.51, p = 0.06) was not. Conclusions: CRP/Alb ratio could be useful as a prognostic indicator of disease severity in COVID-19, but we could not corroborate its potential to predict mortality. The work was conducted at Columbia University College of Physicians and Surgeons at Harlem Hospital.

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Section: Discussioncontrasting

confidence: 70%

Does C reactive protein/Albumin ratio have prognostic value in patients with COVID-19

Kalabin

Mani

Valdivieso

et al. 2021

J Infect Dev Ctries

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“…Besides, we found that age, gender, comorbidities, or the presence of fever on presentation did not show a significant effect on the tested outcomes. COVID-19 induces generalized inflammation, which can cause serious multiple organ damage and complicate the infection [ 26 , 27 ]. Therefore, assessment of the laboratory parameters should be adequately done to avoid these complications.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 in Saudi Patients With Sickle Cell Disease: A Retrospective Multi-Center Study

Kashari¹,

Alghamdi²,

Al‐Hebshi³

et al. 2021

Cureus

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Background The prevalence of sickle cell disease (SCD) within Saudi Arabia is relatively high, with an estimated 145/10,000 cases. There is an urgent need for researching many aspects of the Coronavirus disease of 2019 (COVID-19) due to the widespread of the virus among SCD patients in Saudi Arabia. The aim of this study is to determine how COVID-19 affects SCD patients in order to reach the best strategy for their management protocols. Methods This is a retrospective chart review study from a multi-center in Saudi Arabia that evaluated a total of 33 patients with sickle cell anemia/disease who were confirmed to have COVID-19. The diagnosis of COVID-19 was confirmed by using the reverse transcription-polymerase chain reaction (RT-PCR) tests based on the nasopharyngeal swabs of the included patients. Results The mean age of patients was 10.75+9.11 years, and nearly all patients (n= 32; 96.9%) were Saudi, and 48.4% of them were females. Twenty-two patients were admitted (59.5%); the main reasons for admission included vaso-occlusive crisis (VOC) only (n= 6; 27.3%), fever (n= 6; 27.3%), acute chest syndrome (n= 5; 22.7%), and VOC combined with other conditions (n= 4; 18.2%). During hospitalization, 54.1% of the patients received at least one medication, while antibiotics (54.1%), analgesia (32.4%), anticoagulants (16.2%), and steroids (16.2%) were the most commonly administered drugs. The mean length of hospitalization was 7.6±4.5 days, with only one patient (2.7%) requiring intensive care unit admission and assisted ventilation. Conclusion The overall prognosis was good since only one patient has passed away, while all others recovered and, subsequently, were discharged. Manifestations, laboratory investigations, and management modalities should be utilized promptly to enhance the prognosis and obtain better outcomes.

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“…In the same context, because high IL-6 levels and low lymphocyte counts have been connected to the severity and in-hospital mortality of COVID-19, in a study by Yang and colleagues, the IL-6/lymphocyte ratio (IL-6/L, reversed) was described as a novel biomarker to conduct risk stratification in COVID-19 patients [7]. Other studies have found that having a high IL-6/L is an independent risk factor for disease progression and a poor prognosis [29, 30]. The decrease in lymphocyte numbers caused by IL-6-mediated inhibition of T cell activation explained the high in COVID-19 [31].…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, El-Shabrawy and colleagues have found that the CRP/alb was a predictive factor of COVID-19 mortality. 28…”

Section: Discussionmentioning

confidence: 99%

The Role of CRP, Interleukin-6 and Their Derived Immune-Inflammatory Indices in Early Prediction of Severity and Mortality of COVID-19 Patients

Taha

Shata

Baioumy³

et al. 2021

Preprint

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BackgroundIn coronavirus disease 2019 (COVID-19), finding sensitive biomarkers is critical for detecting severe cases early and intervening effectively.ObjectivesTo compare and evaluate the prognostic value of C-reactive protein (CRP), interleukin-6 (IL-6) and their derived immune-inflammatory indices (CRP/albumin (CRP/alb), lymphocyte/CRP (L/CRP), and lymphocyte/IL-6 (L/IL-6)) in COVID-19 patients.MethodsOn admission, 85 confirmed COVID-19 patients’ measured and collected laboratory data were obtained and compared.ResultsLevels of CRP, IL-6 and CRP/alb were significantly higher (P=0.001) in severe patients and in non-survivors, but L/CRP and L/IL-6 were significantly lower (P=0.001). The best predictive performance for COVID-19 severity was observed at 1.65 for CRP/alb and 260.86 for L/CRP with 84.7% diagnostic accuracy for both. The best diagnostic accuracy for COVID-19 in-hospital mortality was 87.1% by IL-6 at 120 pg/ml and 85.9% by L/IL-6 at 5.40. The performance of the combined prediction was better than the single prediction by one biomarker. IL-6 was an independent risk factor associated with severe disease development (odds ratio (OR): 1.033; 95% confidence interval (CI): 1.002-1.066).ConclusionsPretreatment values of CRP, IL-6 and their derived indices could be included in the diagnostic work-up of COVID-19 to stratify disease severity and predict outcomes.

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Interleukin-6 and C-reactive protein/albumin ratio as predictors of COVID-19 severity and mortality

Cited by 51 publications

References 30 publications

Does C reactive protein/Albumin ratio have prognostic value in patients with COVID-19

Does C reactive protein/Albumin ratio have prognostic value in patients with COVID-19

COVID-19 in Saudi Patients With Sickle Cell Disease: A Retrospective Multi-Center Study

The Role of CRP, Interleukin-6 and Their Derived Immune-Inflammatory Indices in Early Prediction of Severity and Mortality of COVID-19 Patients

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