The effect of CRP/albumin ratio on prognosis of hospitalized patients due to COVID-19

Nesrin Şen; Mehmet Tezcan; Gizem Dogan Gokce; Nilüfer Zorlutuna Kaymak; Sevtap Acer; Ayşe Alga Batırel

doi:10.22391/fppc.1132063

Araştırma Makalesi

COVID-19 nedeniyle hastanede yatan hastaların CRP/albümin oranının prognoz üzerine etkisi

Yıl 2022, Cilt: 7 Sayı: 5, 132 - 136, 30.12.2022

Nesrin Şen Mehmet Tezcan Gizem Dogan Gokce Nilüfer Zorlutuna Kaymak Sevtap Acer Ayşe Alga Batırel

https://doi.org/10.22391/fppc.1132063

Öz

Giriş: SARS-Cov-2 virüsünün neden olduğu COVID-19 hastalığı farklı şiddette klinik spektrumlar ile karakterize edilmiştir. Koagülopati ve inflamasyon COVID-19 şiddeti ile ilişkili en önemli faktörlerdir. Enflamasyon ve pıhtılaşma faktörlerinin biyobelirteç kullanımı henüz netleştirilememiştir. Mevcut çalışma inflamasyon belirteci olan CRP/Albümin düzeyinin COVID-19 hastalık seyrinin tahminindeki rolünü incelemeyi amaçlamıştır.

Yöntem: Pandemi servisinde Nisan-Mayıs 2020 tarihleri arasında yatarak tedavi gören 457 COVID-19 hastasının demografik, laboratuvar ve hastalık seyirleri retrospektif olarak analiz edildi. Hastaların CRP/Albümin oranı ile hastalık şiddeti, hastanede kalış süresi ve prognoz arasındaki ilişki analiz edildi.

Bulgular: Hastaların yoğun bakıma yatış oranı %10,5 (n=48), mekanik ventilasyon ihtiyacı %8,1 (n=37) ve ölüm oranı %1,3 (n=6) idi. Akciğer infiltrasyonu olanlarda (p=0,005), yoğun bakıma alınanlarda (p<0,001) ve mekanik ventilasyon ihtiyacı olanlarda (p<0,001) CRP/albümin oranı istatistiksel olarak yüksekti. Hastanede kalış süresi ile CRP/albümin oranı arasında pozitif anlamlı korelasyon saptandı (r=0,412, p < 0,001)

Sonuç: CRP/Albümin oranının hastaların yoğun bakım ünitesine erken transferinde, MV ihtiyacı olanların erken tespitinde ve akciğer infiltrasyonun tespitinde doktorlara yardımcı bir belirteç olabileceği düşünülmektedir.

Anahtar kelimeler: COVID-19, CRP/albümin oranı, prognoz

Anahtar Kelimeler

covid-19, CRP/albumin oranı, prognoz

Kaynakça

1. Ciotti M, Ciccozzi M, Terrinoni A, Jiang WC, Wang CB, Bernardini S. The COVID-19 pandemic. Crit Rev Clin Lab Sci. 2020;57(6):365-88. https://doi.org/10.1080/10408363.2020.1783198
2. Velavan TP, Meyer CG. The COVID-19 epidemic. Trop Med Int Health. 2020;25(3):278-80. https://doi.org/10.1111/tmi.13383
3. WHO Coronavirus Disease (COVID-19) Dashboard with Vaccination Data WHO Coronavirus (COVID-19) Dashboard with Vaccination Data. World Heal Organ [database on the Internet]2021. https://COVID19.who.int/?mapFilter=vaccinationsAccess Date: December 19, 2022)
4. Zhu J, Zhong Z, Ji P, Li H, Li B, Pang J, et al. Clinicopathological characteristics of 8697 patients with COVID-19 in China: a meta-analysis. Fam Med Community Health. 2020;8(2): e000406.https://doi.org/10.1136/fmch-2020-000406
5. Jegede O, Raman AA, Tiongson B, Garlapati PR, Hershberger J, Gayam V. Clinical characteristics, hospital course, and outcomes among COVID-19 positive patients with mental illness in a community hospital in New York City. Int J Ment Health 2021; 50:4-5. https://doi.org/10.1080/00207411.2020.1845567
6. Lippi G, Plebani M. Laboratory abnormalities in patients with COVID-2019 infection. Clin Chem Lab Med. 2020;58(7):1131-4. https://doi.org/10.1515/cclm-2020-0198
7. Ponti G, Maccaferri M, Ruini C, Tomasi A, Ozben T. Biomarkers associated with COVID-19 disease progression. Crit Rev Clin Lab Sci. 2020;57(6):389-99. https://doi.org/10.1080/10408363.2020.1770685
8. Pourbagheri-Sigaroodi A, Bashash D, Fateh F, Abolghasemi H. Laboratory findings in COVID-19 diagnosis and prognosis. Clin Chim Acta. 2020; 510:475-82. https://doi.org/10.1016/j.cca.2020.08.019
9. Tan C, Huang Y, Shi F, Tan K, Ma Q, Chen Y, et al. C-reactive protein correlates with computed tomographic findings and predicts severe COVID-19 early. J Med Virol. 2020;92(7):856-62. https://doi.org/10.1002/jmv.25871
10. Thijs LG, Hack CE. Time course of cytokine levels in sepsis. Intensive Care Med. 1995;2021(2):258-63. https://doi.org/10.1007/BF01740764
11. Rabbani G, Ahn SN. Review: Roles of human serum albumin in prediction, diagnoses and treatment of COVID-19. Int J Biol Macromol. 2021;193(Pt A)948-55.
12. Aziz M, Fatima R, Lee-Smith W, Assaly R. The association of low serum albumin level with severe COVID-19: a systematic review and meta-analysis. Crit Care. 2020;24(1):255. https://doi.org/10.1186/s13054-020-02995-3
13. Kim MH, Ahn JY, Song JE, Choi H, Ann HW, Kim JK, et al. The C-reactive protein/albumin ratio as an independent predictor of mortality in patients with severe sepsis or septic shock treated with early goal-directed therapy. PLoS One 2015;10(7): e0132109. https://doi.org/10.1371/journal.pone.0132109
14. Atalay E, Erdogdu HI, Tur BK, Deniz BLS, Karabag Y, Ardic S. The relationship between c reactive protein/albumin ratio and 1-year mortality in hospitalized elderly COPD patients with acute exacerbation. Turk JGeriatr 2019; 22:9-17. https://doi.org/10.31086/tjgeri.2019150567
15. Ranzani OT, Zampieri FG, Forte DN, Azevedo LCP, Park M. C-Reactive Protein/Albumin Ratio Predicts 90-Day mortality of septic patients. PLoS One. 2013;8(3): e59321. https://doi.org/10.1371/journal.pone.0059321
16. Sunar I, Ataman S. Serum C-Reactive Protein/Albumin Ratio in Rheumatoid Arthritis and its relationship with disease activity, Physical Function, and Quality of Life. Arch Rheumatol. 2020;35(2):247-53. https://doi.org/10.46497/ArchRheumatol.2020.7456
17. Sun R, Sun X, Yang H, Liu Q. Retrospective analysis of serum C-reactive protein/albumin ratio for the prognosis of the adult patients with sepsis. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2016;28(5):413-7.
18. Haruki K, Shiba H, Shirai Y, Horiuchi T, Iwase R, Fujiwara Y, et al. The C-reactive Protein to albumin Ratio predicts long-term outcomes in patients with pancreatic cancer after pancreatic resection. World J Surg. 2016;40(9):2254-60. https://doi.org/10.1007/s00268-016-3491-4
19. COVID-19 The Guide (Science Board Study) Ministry of Health 02.04.2020. https://COVID19rehberi.com/wp-content/uploads/2020/04/COVID19_Eriskin_Hasta_Tedavisi_02042020.pdf (Access Date: December 19, 2022)
20. Cellina M, Orsi M, ValentiPittino C, Toluian T, Oliva G. Chest computed tomography findings of COVID-19 pneumonia: pictorial essay with literature review. Jpn J Radiol. 2020;38(11):1012-9. https://doi.org/10.1007/s11604-020-01010-7
21. Thompson S, Bohn MK, Mancini N, Loh TP, Wang CB, Grimmler M, et al. IFCC Interim guidelines on biochemical/hematological monitoring of COVID-19 patients. Clin Chem Lab Med. 2020;58(12):2009-16.
22. de la Rica R, Borges M, Gonzalez FM. COVID-19: In the eye of the cytokine storm. Front Immunol. 2020; 11:558898. https://doi.org/10.3389/fimmu.2020.558898
23. Fairclough E, Cairns E, Hamilton J, Kelly C. Evaluation of a modified early warning system for acute medical admissions and comparison with C-reactive protein/albumin ratio as a predictor of patient outcome. Clin Med (Lond). 2009;9(1):30-3. https://doi.org/10.7861/clinmedicine.9-1-30
24. Lucijanić M SJ, Atić A, Čikara T, Osmani B, Barišić-Jaman M, et al. Clinical and prognostic significance of C-reactive protein to albumin ratio in hospitalized coronavirus disease 2019 (COVID-19) patients: Data on 2309 patients from a tertiary center and validation in an independent cohort. Wien KlinWochenschr. 2022;134(9-10):377-384. https://doi.org/10.1007/s00508-021-01999-5
25. Bahadirli S, Kurt E. Predictive value of C-reactive protein/albumin ratio in predicting poor outcome of hospitalized patients with COVID-19. J Heal Sci Med 2021; 4:505-10. https://doi.org/10.32322/jhsm.945522
26. Kayhan S, Kozan H. Predictive Role of C-Reactive Protein/Albumin Ratio in patients with critical COVID-19 patients. JHarran UniMedFac. 2021:361-4. https://doi.org/10.35440/hutfd.1001970
27. Lee JH, Kim J, Kim K, Jo YH, Rhee JE, Kim TY, et al. Albumin and C-reactive protein have prognostic significance in patients with community-acquired pneumonia. J Crit Care 2011; 26:287-94. https://doi.org/10.1016/j.jcrc.2010.10.007
28. Saylik F, Akbulut T, Kaya S. Can C-Reactive protein to albumin ratio predict in-hospital death rate due to COVID-19 in patients with hypertension? Angiology. 2021;72(10):947-52. https://doi.org/10.1177/00033197211012145

The effect of CRP/albumin ratio on prognosis of hospitalized patients due to COVID-19

Yıl 2022, Cilt: 7 Sayı: 5, 132 - 136, 30.12.2022

Nesrin Şen Mehmet Tezcan Gizem Dogan Gokce Nilüfer Zorlutuna Kaymak Sevtap Acer Ayşe Alga Batırel

https://doi.org/10.22391/fppc.1132063

Öz

Introduction: COVID-19 disease caused by the SARS-Cov-2 virus is characterized by clinical spectra of varying severity. Coagulopathy and inflammation are the most important factors associated with COVID-19 severity. The use of a biomarker of inflammation and coagulation factors has not yet been clarified. The present study aimed to examine the role of CRP/Albumin, an inflammation marker, in predicting the course of COVID-19 disease.

Methods: The Demographic, laboratory, and prognosis of 457 patients who were hospitalized during the COVID-19 pandemic service between April and May 2020 were analyzed retrospectively. The relationship between the patients' CRP/Albumin ratio and disease severity, length of hospital stays, and prognosis were analyzed.

Results: The rate of hospitalization in the intensive care unit was 10.5% (n=48), mechanical ventilation was 8.1% (n=37), and death was 1.3% (n=6). The CRP/albumin ratio was statistically higher in those with lung infiltration (p=0.005), those who were taken to the intensive care unit (p<0.001), and those who needed mechanical ventilation (p<0.001). A positive significant correlation was found between the length of hospital stay and the CRP/albumin ratio(r=0.412, p < 0.001).

Conclusion: The CRP/Albumin ratio is thought to be an auxiliary marker for doctors in the early transfer of patients to the intensive care unit, the early detection of those in need of MV, and the determination of lung infiltration.

Keywords: COVID-19, CRP/albumin ratio, prognosis

Anahtar Kelimeler

covid-19, CRP/albumin ratio, prognosis

Kaynakça

1. Ciotti M, Ciccozzi M, Terrinoni A, Jiang WC, Wang CB, Bernardini S. The COVID-19 pandemic. Crit Rev Clin Lab Sci. 2020;57(6):365-88. https://doi.org/10.1080/10408363.2020.1783198
2. Velavan TP, Meyer CG. The COVID-19 epidemic. Trop Med Int Health. 2020;25(3):278-80. https://doi.org/10.1111/tmi.13383
3. WHO Coronavirus Disease (COVID-19) Dashboard with Vaccination Data WHO Coronavirus (COVID-19) Dashboard with Vaccination Data. World Heal Organ [database on the Internet]2021. https://COVID19.who.int/?mapFilter=vaccinationsAccess Date: December 19, 2022)
4. Zhu J, Zhong Z, Ji P, Li H, Li B, Pang J, et al. Clinicopathological characteristics of 8697 patients with COVID-19 in China: a meta-analysis. Fam Med Community Health. 2020;8(2): e000406.https://doi.org/10.1136/fmch-2020-000406
5. Jegede O, Raman AA, Tiongson B, Garlapati PR, Hershberger J, Gayam V. Clinical characteristics, hospital course, and outcomes among COVID-19 positive patients with mental illness in a community hospital in New York City. Int J Ment Health 2021; 50:4-5. https://doi.org/10.1080/00207411.2020.1845567
6. Lippi G, Plebani M. Laboratory abnormalities in patients with COVID-2019 infection. Clin Chem Lab Med. 2020;58(7):1131-4. https://doi.org/10.1515/cclm-2020-0198
7. Ponti G, Maccaferri M, Ruini C, Tomasi A, Ozben T. Biomarkers associated with COVID-19 disease progression. Crit Rev Clin Lab Sci. 2020;57(6):389-99. https://doi.org/10.1080/10408363.2020.1770685
8. Pourbagheri-Sigaroodi A, Bashash D, Fateh F, Abolghasemi H. Laboratory findings in COVID-19 diagnosis and prognosis. Clin Chim Acta. 2020; 510:475-82. https://doi.org/10.1016/j.cca.2020.08.019
9. Tan C, Huang Y, Shi F, Tan K, Ma Q, Chen Y, et al. C-reactive protein correlates with computed tomographic findings and predicts severe COVID-19 early. J Med Virol. 2020;92(7):856-62. https://doi.org/10.1002/jmv.25871
10. Thijs LG, Hack CE. Time course of cytokine levels in sepsis. Intensive Care Med. 1995;2021(2):258-63. https://doi.org/10.1007/BF01740764
11. Rabbani G, Ahn SN. Review: Roles of human serum albumin in prediction, diagnoses and treatment of COVID-19. Int J Biol Macromol. 2021;193(Pt A)948-55.
12. Aziz M, Fatima R, Lee-Smith W, Assaly R. The association of low serum albumin level with severe COVID-19: a systematic review and meta-analysis. Crit Care. 2020;24(1):255. https://doi.org/10.1186/s13054-020-02995-3
13. Kim MH, Ahn JY, Song JE, Choi H, Ann HW, Kim JK, et al. The C-reactive protein/albumin ratio as an independent predictor of mortality in patients with severe sepsis or septic shock treated with early goal-directed therapy. PLoS One 2015;10(7): e0132109. https://doi.org/10.1371/journal.pone.0132109
14. Atalay E, Erdogdu HI, Tur BK, Deniz BLS, Karabag Y, Ardic S. The relationship between c reactive protein/albumin ratio and 1-year mortality in hospitalized elderly COPD patients with acute exacerbation. Turk JGeriatr 2019; 22:9-17. https://doi.org/10.31086/tjgeri.2019150567
15. Ranzani OT, Zampieri FG, Forte DN, Azevedo LCP, Park M. C-Reactive Protein/Albumin Ratio Predicts 90-Day mortality of septic patients. PLoS One. 2013;8(3): e59321. https://doi.org/10.1371/journal.pone.0059321
16. Sunar I, Ataman S. Serum C-Reactive Protein/Albumin Ratio in Rheumatoid Arthritis and its relationship with disease activity, Physical Function, and Quality of Life. Arch Rheumatol. 2020;35(2):247-53. https://doi.org/10.46497/ArchRheumatol.2020.7456
17. Sun R, Sun X, Yang H, Liu Q. Retrospective analysis of serum C-reactive protein/albumin ratio for the prognosis of the adult patients with sepsis. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2016;28(5):413-7.
18. Haruki K, Shiba H, Shirai Y, Horiuchi T, Iwase R, Fujiwara Y, et al. The C-reactive Protein to albumin Ratio predicts long-term outcomes in patients with pancreatic cancer after pancreatic resection. World J Surg. 2016;40(9):2254-60. https://doi.org/10.1007/s00268-016-3491-4
19. COVID-19 The Guide (Science Board Study) Ministry of Health 02.04.2020. https://COVID19rehberi.com/wp-content/uploads/2020/04/COVID19_Eriskin_Hasta_Tedavisi_02042020.pdf (Access Date: December 19, 2022)
20. Cellina M, Orsi M, ValentiPittino C, Toluian T, Oliva G. Chest computed tomography findings of COVID-19 pneumonia: pictorial essay with literature review. Jpn J Radiol. 2020;38(11):1012-9. https://doi.org/10.1007/s11604-020-01010-7
21. Thompson S, Bohn MK, Mancini N, Loh TP, Wang CB, Grimmler M, et al. IFCC Interim guidelines on biochemical/hematological monitoring of COVID-19 patients. Clin Chem Lab Med. 2020;58(12):2009-16.
22. de la Rica R, Borges M, Gonzalez FM. COVID-19: In the eye of the cytokine storm. Front Immunol. 2020; 11:558898. https://doi.org/10.3389/fimmu.2020.558898
23. Fairclough E, Cairns E, Hamilton J, Kelly C. Evaluation of a modified early warning system for acute medical admissions and comparison with C-reactive protein/albumin ratio as a predictor of patient outcome. Clin Med (Lond). 2009;9(1):30-3. https://doi.org/10.7861/clinmedicine.9-1-30
24. Lucijanić M SJ, Atić A, Čikara T, Osmani B, Barišić-Jaman M, et al. Clinical and prognostic significance of C-reactive protein to albumin ratio in hospitalized coronavirus disease 2019 (COVID-19) patients: Data on 2309 patients from a tertiary center and validation in an independent cohort. Wien KlinWochenschr. 2022;134(9-10):377-384. https://doi.org/10.1007/s00508-021-01999-5
25. Bahadirli S, Kurt E. Predictive value of C-reactive protein/albumin ratio in predicting poor outcome of hospitalized patients with COVID-19. J Heal Sci Med 2021; 4:505-10. https://doi.org/10.32322/jhsm.945522
26. Kayhan S, Kozan H. Predictive Role of C-Reactive Protein/Albumin Ratio in patients with critical COVID-19 patients. JHarran UniMedFac. 2021:361-4. https://doi.org/10.35440/hutfd.1001970
27. Lee JH, Kim J, Kim K, Jo YH, Rhee JE, Kim TY, et al. Albumin and C-reactive protein have prognostic significance in patients with community-acquired pneumonia. J Crit Care 2011; 26:287-94. https://doi.org/10.1016/j.jcrc.2010.10.007
28. Saylik F, Akbulut T, Kaya S. Can C-Reactive protein to albumin ratio predict in-hospital death rate due to COVID-19 in patients with hypertension? Angiology. 2021;72(10):947-52. https://doi.org/10.1177/00033197211012145

Toplam 28 adet kaynakça vardır.

Ayrıntılar

Birincil Dil	İngilizce
Konular	İç Hastalıkları
Bölüm	Araştırma Makalesi (Original Article)
Yazarlar	Nesrin Şen 0000-0003-0966-0075 Mehmet Tezcan 0000-0002-1753-4936 Gizem Dogan Gokce 0000-0003-1328-7103 Nilüfer Zorlutuna Kaymak 0000-0002-9673-824X Sevtap Acer 0000-0002-4805-0555 Ayşe Alga Batırel 0000-0002-6005-636X
Yayımlanma Tarihi	30 Aralık 2022
Gönderilme Tarihi	17 Haziran 2022
Kabul Tarihi	20 Kasım 2022
Yayımlandığı Sayı	Yıl 2022Cilt: 7 Sayı: 5

Kaynak Göster

APA	Şen, N., Tezcan, M., Dogan Gokce, G., Zorlutuna Kaymak, N., vd. (2022). The effect of CRP/albumin ratio on prognosis of hospitalized patients due to COVID-19. Family Practice and Palliative Care, 7(5), 132-136. https://doi.org/10.22391/fppc.1132063
AMA	Şen N, Tezcan M, Dogan Gokce G, Zorlutuna Kaymak N, Acer S, Alga Batırel A. The effect of CRP/albumin ratio on prognosis of hospitalized patients due to COVID-19. Fam Pract Palliat Care. Aralık 2022;7(5):132-136. doi:10.22391/fppc.1132063
Chicago	Şen, Nesrin, Mehmet Tezcan, Gizem Dogan Gokce, Nilüfer Zorlutuna Kaymak, Sevtap Acer, ve Ayşe Alga Batırel. “The Effect of CRP/Albumin Ratio on Prognosis of Hospitalized Patients Due to COVID-19”. Family Practice and Palliative Care 7, sy. 5 (Aralık 2022): 132-36. https://doi.org/10.22391/fppc.1132063.
EndNote	Şen N, Tezcan M, Dogan Gokce G, Zorlutuna Kaymak N, Acer S, Alga Batırel A (01 Aralık 2022) The effect of CRP/albumin ratio on prognosis of hospitalized patients due to COVID-19. Family Practice and Palliative Care 7 5 132–136.
IEEE	N. Şen, M. Tezcan, G. Dogan Gokce, N. Zorlutuna Kaymak, S. Acer, ve A. Alga Batırel, “The effect of CRP/albumin ratio on prognosis of hospitalized patients due to COVID-19”, Fam Pract Palliat Care, c. 7, sy. 5, ss. 132–136, 2022, doi: 10.22391/fppc.1132063.
ISNAD	Şen, Nesrin vd. “The Effect of CRP/Albumin Ratio on Prognosis of Hospitalized Patients Due to COVID-19”. Family Practice and Palliative Care 7/5 (Aralık 2022), 132-136. https://doi.org/10.22391/fppc.1132063.
JAMA	Şen N, Tezcan M, Dogan Gokce G, Zorlutuna Kaymak N, Acer S, Alga Batırel A. The effect of CRP/albumin ratio on prognosis of hospitalized patients due to COVID-19. Fam Pract Palliat Care. 2022;7:132–136.
MLA	Şen, Nesrin vd. “The Effect of CRP/Albumin Ratio on Prognosis of Hospitalized Patients Due to COVID-19”. Family Practice and Palliative Care, c. 7, sy. 5, 2022, ss. 132-6, doi:10.22391/fppc.1132063.
Vancouver	Şen N, Tezcan M, Dogan Gokce G, Zorlutuna Kaymak N, Acer S, Alga Batırel A. The effect of CRP/albumin ratio on prognosis of hospitalized patients due to COVID-19. Fam Pract Palliat Care. 2022;7(5):132-6.

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Makale Dosyaları

Tam Metin

COVID-19 nedeniyle hastanede yatan hastaların CRP/albümin oranının prognoz üzerine etkisi

Öz

Anahtar Kelimeler

Kaynakça

The effect of CRP/albumin ratio on prognosis of hospitalized patients due to COVID-19

Öz

Anahtar Kelimeler

Kaynakça

Ayrıntılar

Kaynak Göster

Family Practice and Palliative Care ISSN 2458-8865 E-ISSN 2459-1505