Abstract
C-reactive protein-to-albumin ratio (CAR) has been used as an indicator of prognosis in various diseases. Here, we intended to assess the CAR’s diagnostic power in early differentiation of hospitalized severe COVID-19 cases. In this retrospectively designed study, we evaluated 197 patients in total. They were divided into two groups based on their severity of COVID-19 as non-severe (n = 113) and severe (n = 84). The comparison of groups’ demographic data, comorbidities, clinical symptoms, and laboratory test results were done. Laboratory data of the patients within the first 24 h after admission to the hospital were evaluated. The calculation of receiver operating characteristic (ROC) curve was used to determine the diagnostic power of CAR in differentiating severity of COVID-19. Independent risk factors predictive of COVID-19 severity were determined by using logistic regression analysis. Although lymphocyte count levels were lower, severe COVID-19 patients had higher mean age, higher levels of neutrophil count, CRP, aspartate aminotransferase (AST), ferritin, and prothrombin time (P < 0.05). Compared with non-severe patients (median, 0.23 [IQR = 0.07-1.56]), patients with severe COVID-19 had higher CAR levels (median, 1.66 [IQR = 0.50-3.35]; P < 0.001). Age (OR = 1.046, P = 0.003), CAR (OR = 1.264, P = 0.037), and AST (OR = 1.029, P = 0.037) were independent risk factors for severe COVID-19 based on the multivariate logistic regression analysis. ROC curve analysis assigned 0.9 as the cut-off value for CAR for differentiation of severe COVID-19 (area under the curve = 0.718, 69.1% sensitivity, 70.8% specificity, P < 0.001). CAR is a useful marker in early differentiation of severity in patients hospitalized due to COVID-19 that have longer hospital stay and higher mortality.
Keywords: C-reactive protein to albumin ratio; COVID-19; SARS-CoV-2.
【저자키워드】 COVID-19, SARS-CoV-2, C-reactive protein to albumin ratio, 【초록키워드】 SARS-CoV-2, Diseases, Hospitalized, Mortality, severe COVID-19, Clinical symptoms, Prognosis, severity, hospital, neutrophil, Comorbidities, diagnostic, COVID-19 severity, C-reactive protein, CRP, ferritin, risk factor, Laboratory, Lymphocyte count, lymphocyte, sensitivity, specificity, ROC, severity of COVID-19, Patient, albumin, Aspartate aminotransferase, AST, age, differentiation, group, characteristic, Admission, prothrombin, marker, Analysis, ROC Curve, Hospital stay, Laboratory test, Prothrombin time, Predictive, receiver operating characteristic, determined by, Indicator, Logistic regression analysis, two groups, independent risk factors, laboratory data, demographic data, multivariate logistic regression, severe COVID-19 patients, aspartate, neutrophil count, non-severe patients, cut-off value, independent risk factor, multivariate logistic regression analysis, calculation, CAR, was used, the patient, evaluated, median, determine, assigned, two group, non-severe patient, patients hospitalized, severe COVID-19 patient, 【제목키워드】 Hospitalized, C-reactive protein, albumin, utility, severe COVID-19 patient,