Increased pretreatment C-reactive protein-to-albumin ratio predicts severe coronavirus disease 2019

Abstract

Objective The aim of this study was to identify early warning signs for severe coronavirus disease 2019 (COVID-19). Methods We retrospectively analysed the clinical data of 90 patients with COVID-19 from Guanggu District of Hubei Women and Children Medical and Healthcare Center, comprising 60 mild cases and 30 severe cases. The demographic data, underlying diseases, clinical manifestations and laboratory blood test results were compared between the two groups. The cutoff values were determined by receiver operating characteristic curve analysis. Logistic regression analysis was performed to identify the independent risk factors for severe COVID-19. Results The patients with mild and severe COVID-19 had significant differences in terms of cancer incidence, age, pretreatment neutrophil-to-lymphocyte ratio (NLR), and pretreatment C-reactive protein-to-albumin ratio (CAR) ( P =0.000; P =0.008; P=0.000; P =0.000). The severity of COVID-19 was positively correlated with comorbid cancer, age, NLR, and CAR ( P <0.005). Multivariate logistic regression analysis showed that age, the NLR and the CAR were independent risk factors for severe COVID-19 (OR=1.086, P =0.008; OR=1.512, P =0.007; OR=17.652, P =0.001). Conclusion An increased CAR can serve as an early warning sign of severe COVID-19 in conjunction with the NLR and age.

Novel Systemic Inflammation Markers to Predict COVID-19 Prognosis

“…This study concluded the superiority of hsCAR, hsCPAR, and PNI. PNI was superior to NLR in predicting mortality and CAR in predicting disease severity, each in one study (79,82).…”

“…CAR could predict disease severity in two studies (79,91): one comparing it with NLR and finding a higher OR for CAR (OR = 17.652, p = 0.001) than NLR (OR = 1.512, p = 0.007) (79).…”

The Relationship Between Serum Albumin Level and Nutritional Parameters with Mortality Rate, For Icu-Covid-19 Patients at Hazem Mebaireek General Hospital (HMGH), State of Qatar (March to September / 2020)

“…Human serum albumin level (HSAL) widely used in clinical practice, it reflects nutritional status and inflammatory response, which are related to outcomes of cancer treatment, and inflammatory diseases. Previous studies also found that HSAL was significantly lower in patients with severe COVID-19 (10).…”

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

“…After exclusions, 23 studies with a total of 7774 participants remained and were ultimately included in the analysis. 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 The process of study selection is summarised in Supplementary Figure 1 using the PRISMAflowchart. Sixteen studies reported the association of CAR with COVID‐19 outcomes, 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 four studies included FAR, 28 , 29 , 30 , 31 and three studies included both CAR and FAR.…”