tetano
Editor, Senior Moderator
Wien Klin Wochenschr
. 2022 Jan 17.
doi: 10.1007/s00508-021-01999-5. Online ahead of print.
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
Marko Lucijanić[SUP] 1 2 3 [/SUP], Josip Stojić[SUP] 4 5 [/SUP], Armin Atić[SUP] 4 5 [/SUP], Tomislav Čikara[SUP] 4 6 [/SUP], Besa Osmani[SUP] 4 7 [/SUP], Mislav Barišić-Jaman[SUP] 4 8 [/SUP], Ana Andrilović[SUP] 4 5 [/SUP], Petra Bistrović[SUP] 4 6 [/SUP], Anamarija Zrilić Vrkljan[SUP] 4 9 [/SUP], Marko Lagančić[SUP] 4 5 [/SUP], Marko Milošević[SUP] 4 8 [/SUP], Ivan Vukoja[SUP] 10 11 [/SUP], Lovorka Đerek[SUP] 4 12 [/SUP], Tomo Lucijanić[SUP] 4 9 [/SUP], Nevenka Piskač Živković[SUP] 4 13 [/SUP]
Affiliations
Abstract
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.
Keywords: IL‑6; Pneumonia; Prognosis; SARS-CoV‑2; Thromboinflammation.
. 2022 Jan 17.
doi: 10.1007/s00508-021-01999-5. Online ahead of print.
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
Marko Lucijanić[SUP] 1 2 3 [/SUP], Josip Stojić[SUP] 4 5 [/SUP], Armin Atić[SUP] 4 5 [/SUP], Tomislav Čikara[SUP] 4 6 [/SUP], Besa Osmani[SUP] 4 7 [/SUP], Mislav Barišić-Jaman[SUP] 4 8 [/SUP], Ana Andrilović[SUP] 4 5 [/SUP], Petra Bistrović[SUP] 4 6 [/SUP], Anamarija Zrilić Vrkljan[SUP] 4 9 [/SUP], Marko Lagančić[SUP] 4 5 [/SUP], Marko Milošević[SUP] 4 8 [/SUP], Ivan Vukoja[SUP] 10 11 [/SUP], Lovorka Đerek[SUP] 4 12 [/SUP], Tomo Lucijanić[SUP] 4 9 [/SUP], Nevenka Piskač Živković[SUP] 4 13 [/SUP]
Affiliations
- PMID: 35038003
- DOI: 10.1007/s00508-021-01999-5
Abstract
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.
Keywords: IL‑6; Pneumonia; Prognosis; SARS-CoV‑2; Thromboinflammation.
