Can C-Reactive Protein to Albumin Ratio Predict In-Hospital Death Rate Due to COVID-19 in Patients With Hypertension?

Şaylık, Faysal; Akbulut, Tayyar; Kaya, Şafak

doi:10.1177/00033197211012145

Cited by 20 publications

(20 citation statements)

References 39 publications

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“…Worse clinical course including more rapid respiratory deterioration and higher need for intensive level of care as well as higher mortality, have been previously reported to be associated with higher CAR in smaller cohorts of COVID-19 patients [ 10 – 13 ]. Similar observations regarding disease severity were established in non-COVID community-acquired pneumonia patients as well [ 22 – 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…These parameters are thus commonly deranged among other liver blood tests during the COVID-19 infection [ 9 ]. The CRP to albumin ratio (CAR) incorporates deviations of these parameters into a single direction and has been shown to be prognostic of more severe disease and higher mortality if elevated in COVID-19 patients [ 10 – 13 ]. These findings resemble those observed in the context of other chronic inflammatory diseases [ 14 – 17 ].…”

Section: Introductionmentioning

confidence: 99%

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Clinical and prognostic significance of C-reactive protein to albumin ratio in hospitalized coronavirus disease 2019 (COVID-19) patients

Lucijanić

Stojić

Atić

et al. 2022

Wien Klin Wochenschr

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C‑reactive protein (CRP) and albumin are inflammation sensitive parameters that are regulated by interleukin‑6 inflammatory pathways. The CRP to albumin ratio (CAR) integrates these two into a potent clinical parameter whose clinical and prognostic association in the context of coronavirus disease 2019 (COVID-19) have not been well defined. We aimed to investigate the clinical and prognostic significance of CAR in the context of COVID-19 infection. We retrospectively analyzed 2309 consecutive COVID-19 patients hospitalized at a tertiary level hospital in the period from March 2020 to March 2021 who had baseline data for a CAR assessment. Findings were validated in an independent cohort of 1155 patients hospitalized from March 2021 to June 2021. The majority of patients (85.8%) had severe or critical COVID-19 on admission. Median CRP, albumin and CAR levels were 91 mg/L, 32 g/L and 2.92, respectively. Higher CAR was associated with a tendency for respiratory deterioration during hospitalization, increased requirement of high-flow oxygen treatment and mechanical ventilation, higher occurrence of bacteriemia, higher occurrence of deep venous thrombosis, lower occurrence of myocardial infarction, higher 30-day mortality and higher postdischarge mortality rates. We defined and validated four CAR prognostic categories (< 1.0, 1.0–2.9, 3.0–5.9 and ≥ 6.0) with distinct 30-day survival. In the series of multivariate Cox regression models we could demonstrate robust prognostic properties of CAR that was associated with inferior 30-day survival independently of COVID-19 severity, age and comorbidities and additionally independently of COVID-19 severity, CURB-65 and VACO index in both development and validation cohorts. The CAR seems to have a good potential to improve prognostication of hospitalized COVID-19 patients. Supplementary Information The online version of this article (10.1007/s00508-021-01999-5) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical and prognostic significance of C-reactive protein to albumin ratio in hospitalized coronavirus disease 2019 (COVID-19) patients

Lucijanić

Stojić

Atić

et al. 2022

Wien Klin Wochenschr

View full text Add to dashboard Cite

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“…Reply to Letter: "Impact of Hypertension on the Prognosis of COVID-19 Disease and Uncertainties that Need to be Clarified" Faysal Saylik, MD 1 , Tayyar Akbulut, MD 1 and Safak Kaya, MD 2 We thank Sanlialp et al for their comments 1 regarding our study entitled "Can C-reactive protein to albumin ratio predict in-hospital death rate due to COVID-19 in patients with hypertension?" 2 In our study, 2 all hypertensive patients were selected consecutively and then classified as survivors and nonsurvivors. Because this study was conducted early during the COVID-19 pandemic, the diagnosis could have been delayed.…”

mentioning

confidence: 99%

“…We thank Sanlialp et al for their comments 1 regarding our study entitled “Can C-reactive protein to albumin ratio predict in-hospital death rate due to COVID-19 in patients with hypertension?” 2 …”

mentioning

confidence: 99%

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Reply to Letter: “Impact of Hypertension on the Prognosis of COVID-19 Disease and Uncertainties that Need to be Clarified”

Şaylık¹,

Akbulut²,

Kaya

2022

Angiology

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Prognostic value of novel serum biomarkers, including C‐reactive protein to albumin ratio and fibrinogen to albumin ratio, in COVID‐19 disease: A meta‐analysis

Rathore¹,

Oberoi

Iqbal

et al. 2022

Reviews in Medical Virology

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With COVID‐19 still hovering around and threatening the lives of many at‐risk patients, an effective, quick, and inexpensive prognostic method is required. Few studies have shown fibrinogen to albumin ratio (FAR) and C‐reactive protein to albumin ratio (CAR) to be promising as prognostic markers for COVID‐19 disease. However, their implications remain unclear. This meta‐analysis aimed to elucidate the prognostic role of FAR and CAR in COVID‐19 disease. A systematic literature search was undertaken using PubMed and Embase till April 2022. Inverse variance standardised mean difference (SMD) was calculated to report the overall effect size using random effect models. The generic inverse variance random‐effects method was used to pool the area under the curve (AUC) values. All statistical analyses were performed on Revman and MedCalc Software. A total of 23 studies were included. COVID‐19 non‐survivors had a higher CAR on admission compared with survivors (SMD = 1.79 [1.04, 2.55]; p < 0.00001; I 2 = 97%) and patients with a severe COVID‐19 infection had a higher CAR on admission than non‐severe patients (SMD = 1.21 [0.54, 1.89]; p = 0.0004; I 2 = 97%). Similarly, higher mean FAR values on admission were significantly associated with COVID‐19 mortality (SMD = 0.55 [0.32, 0.78]; p < 0.00001; I 2 = 82%). However, no significant association was found between mean FAR on admission and COVID‐19 severity (SMD = 0.54 [−0.09, 1.18]; p = 0.09; I 2 = 91%). The pooled AUC values found that CAR had a good discriminatory‐power to predict COVID‐19 severity (AUC = 0.81 [0.75, 0.86]; p < 0.00001; I 2 = 80%) and mortality (AUC = 0.81 [0.74, 0.87]; p < 0.00001; I 2 = 86%). FAR had a fair discriminatory‐power to predict COVID‐19 severity (AUC = 0.73 [0.64, 0.82]; p < 0.00001; I 2 = 89%). Overall, CAR was a good predictor of both severity and mortality associated with COVID‐19 infection. Similarly, FAR was a satisfactory predictor of COVID‐19 mortality but not severity.

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Can C-Reactive Protein to Albumin Ratio Predict In-Hospital Death Rate Due to COVID-19 in Patients With Hypertension?

Cited by 20 publications

References 39 publications

Clinical and prognostic significance of C-reactive protein to albumin ratio in hospitalized coronavirus disease 2019 (COVID-19) patients

Clinical and prognostic significance of C-reactive protein to albumin ratio in hospitalized coronavirus disease 2019 (COVID-19) patients

Reply to Letter: “Impact of Hypertension on the Prognosis of COVID-19 Disease and Uncertainties that Need to be Clarified”

Prognostic value of novel serum biomarkers, including C‐reactive protein to albumin ratio and fibrinogen to albumin ratio, in COVID‐19 disease: A meta‐analysis

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