Predictive Value of CAR for In-Hospital Mortality in Patients with COVID-19 Pneumonia: A Retrospective Cohort Study

Güney, Başak Çakır; Tastan, Yesim Onal; Doğantekin, Betül; Serindag, Zeliha; Yeniçeri, Murat; Çiçek, Vedat; Kılıç, Şahhan; Şeker, Mehmet; Çınar, Tufan; Hayıroğlu, Mert İlker; Kaplan, Mustafa

doi:10.1016/j.arcmed.2021.02.006

Cited by 29 publications

(26 citation statements)

References 21 publications

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“…In a recent study, the CAR was shown to be an independent predictor of the disease severity in patients with COVID-19 who were hospitalized. 37 Furthermore, Güney et al 38 confirmed that the CAR was an independent indicator of in-hospital mortality in patients with COVID-19.…”

Section: Discussionmentioning

confidence: 95%

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

Şaylık¹,

Akbulut²,

Kaya

2021

Angiology

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Hypertension is one of the main morbidity and mortality risk factors in patients with coronavirus disease 2019 (COVID-19). We investigated the association between the C-reactive protein (CRP) to albumin ratio (CAR) and in-hospital mortality in patients with hypertensive COVID-19. A total of 176 patients with hypertension diagnosed with COVID-19 were included in this study. The CAR was compared between survivors and nonsurvivors. Logistic regression analysis was used to detect independent predictors of mortality due to COVID-19 in patients with hypertension. A cutoff value of CAR was obtained for predicting in-hospital death in patients with hypertensive COVID-19. Kaplan-Meier analysis was performed for survival analysis in the study population. The CAR values were significantly higher in nonsurvivors than in survivors with hypertension. Moreover, the CAR was an independent predictor of in-hospital death in patients with hypertensive COVID-19, as shown in multivariable logistic regression analysis. Receiver operating characteristic analysis yielded a cutoff value of 20.75 for the CAR for predicting in-hospital death in patients with hypertension. Kaplan-Meier curve analysis showed that patients with hypertensive COVID-19 with a CAR value of ≥20.75 had a higher incidence of in-hospital death. The CAR might be used as an independent predictor of in-hospital mortality in patients with hypertensive COVID-19.

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Section: Discussionmentioning

confidence: 95%

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

Şaylık¹,

Akbulut²,

Kaya

2021

Angiology

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“…Furthermore, the OR for CAR in the prediction of severe disease was found to be 1.264, which is too low to be clinically significant [16]. Güney et al investigated the predictive value of CAR for in-hospital mortality in patients with COVID-19 by dividing the cohort into three groups according to their CAR values (17). The authors found the OR as 8.2 between the group with a high CAR value and the reference group, which cannot be considered clinically significant [13,17].…”

Section: Discussionmentioning

confidence: 99%

“…Güney et al investigated the predictive value of CAR for in-hospital mortality in patients with COVID-19 by dividing the cohort into three groups according to their CAR values (17). The authors found the OR as 8.2 between the group with a high CAR value and the reference group, which cannot be considered clinically significant [13,17]. El-Shabrawy et al reported the AUC values as 0.939 and 0.955 for CRP and CAR, respectively and noted that these values were statistically significant in the prediction of 30-day mortality [18].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the ability of the C-reactive protein-to-albumin ratio to predict short-term mortality in patients with COVID-19

Özdemir

Algın

2021

J CLIN MED KAZ

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This study aimed to determine the ability of the C-reactive protein (CRP)-to-albumin ratio (CAR) to predict short-term mortality in patients with COVID-19.Material and methods: This retrospective, observational, cohort study included patients with COVID-19. The patients' demographics, clinical characteristics, CRP, albumin, CAR, blood urea nitrogen, creatinine, highsensitive cardiac troponin I and all-cause mortality within 30 days after admission were noted. The receiver operating characteristic curve analysis was performed, and odds ratios (OR) were calculated to determine the discriminative ability of the parameters.Results: A total of 103 patients with a median of age of 57 (25th -75th percentiles: 32-76) years were included in the study. The rate of 30-day mortality was 4.8% for the study cohort. According to the best Youden's index, the cutoff value for CRP was determined as 66.67 (sensitivity: 80%, specificity: 78.6%), and the area under curve (AUC) value was 0.801 (95% confidence interval [CI]: 71.1-87.3). According to the best Youden's index, the cut-off value for CAR was 0.18 (sensitivity: 80%, specificity: 78.6%), and the AUC value was 0.806 (95% CI: 71.6-87.7). There was no statistically significant difference between the AUC values of CRP and CAR (DeLong equality test, p=0.938). The OR of CRP (>66.67 mg/L) and CAR (>0.18) for 30-day mortality were 14.667 (95% CI: 1.555-138.299) and 13.818 (95% CI: 1.468-130.076), respectively.Conclusion: CAR was not useful in predicting 30-day mortality in patients with COVID-19. The calculation of CAR rather than CRP had no clinically significant contribution to the prediction of 30-day mortality in this patient group.

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“…Based on current data, CRP/Alb ratio could predict adverse clinical outcomes. Recently, studies with small sample sizes have shown a significant increase in the CRP/Alb ratio in patients with severe COVID-19 and nonsurvivors [13,14]. However, its correlation with the risk of clinical progression and deterioration in patients with severe COVID-19 has rarely been reported.…”

Section: Introductionmentioning

confidence: 99%

Early Prediction of Disease Progression in Patients with Severe COVID-19 Using C-Reactive Protein to Albumin Ratio

Chen

et al. 2021

Disease Markers

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Background. Early identification of patients with severe coronavirus disease (COVID-19) at an increased risk of progression may promote more individualized treatment schemes and optimize the use of medical resources. This study is aimed at investigating the utility of the C-reactive protein to albumin (CRP/Alb) ratio for early risk stratification of patients. Methods. We retrospectively reviewed 557 patients with COVID-19 with confirmed outcomes (discharged or deceased) admitted to the West Court of Union Hospital, Wuhan, China, between January 29, 2020 and April 8, 2020. Patients with severe COVID-19 ( n = 465 ) were divided into stable ( n = 409 ) and progressive ( n = 56 ) groups according to whether they progressed to critical illness or death during hospitalization. To predict disease progression, the CRP/Alb ratio was evaluated on admission. Results. The levels of new biomarkers, including neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, CRP/Alb ratio, and systemic immune-inflammation index, were higher in patients with progressive disease than in those with stable disease. Correlation analysis showed that the CRP/Alb ratio had the strongest positive correlation with the sequential organ failure assessment score and length of hospital stay in survivors. Multivariate logistic regression analysis showed that percutaneous oxygen saturation (SpO2), D-dimer levels, and the CRP/Alb ratio were risk factors for disease progression. To predict clinical progression, the areas under the receiver operating characteristic curves of Alb, CRP, CRP/Alb ratio, SpO2, and D-dimer were 0.769, 0.838, 0.866, 0.107, and 0.748, respectively. Moreover, patients with a high CRP/Alb ratio (≥1.843) had a markedly higher rate of clinical deterioration ( log − rank p < 0.001 ). A higher CRP/Alb ratio (≥1.843) was also closely associated with higher rates of hospital mortality, ICU admission, invasive mechanical ventilation, and a longer hospital stay. Conclusion. The CRP/Alb ratio can predict the risk of progression to critical disease or death early, providing a promising prognostic biomarker for risk stratification and clinical management of patients with severe COVID-19.

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Predictive Value of CAR for In-Hospital Mortality in Patients with COVID-19 Pneumonia: A Retrospective Cohort Study

Cited by 29 publications

References 21 publications

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

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

Evaluation of the ability of the C-reactive protein-to-albumin ratio to predict short-term mortality in patients with COVID-19

Early Prediction of Disease Progression in Patients with Severe COVID-19 Using C-Reactive Protein to Albumin Ratio

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