Novel biochemical prognostic indicators in COVID-19: Can CRP/albumin, urea/albumin, and LDH/albumin ratios be used to predict mortality and length of hospitalization? (original) (raw)
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Journal of Laboratory Physicians
Introduction An array of routinely accessible serum biomarkers was assessed to explore their overall impact on severity and mortality in coronavirus disease 2019. Materials and Methods A retrospective analysis of 1,233 adults was conducted. The study groups comprised 127 nonsurvivors and 1,106 survivors. Data for demographic details, clinical presentations, and laboratory reports were recorded from the medical record section. The predictors were analyzed for their influence on mortality. Results The mean (+ standard deviation) age of the patients in the nonsurvivor group was 58.8 (13.8) years. The mean age (56.4 years) was highest in severe grade patients. The odds ratio for death was 2.72 times for patients above the age of 40 years. About 46% of nonsurvivors died within 5 days of admission. Males were found to be more prone to death than females by a factor of 1.36. Serum urea depicted highest sensitivity (85%) for nonsurvival at 52.5 mg/dL. Serum albumin (3.23 g/dL), albumin-to-g...
International Journal of Health and Allied Sciences
Introduction: Coronavirus diseases (COVID-19), the global pandemic has posed a serious threat to the health of individuals across the world and is associated with increased morbidity and mortality. Several biochemical and hematological parameters are found to be altered in these patients and there is a need to identify a suitable biomarker that can help in better risk stratification of these patients. Hence in this study, we intend to evaluate the clinical utility of these parameters to predict severity and mortality in COVID-19 patients. Material & methods: A retrospective, observational study was conducted in a tertiary care hospital involving Reverse Transcription Polymerase Chain Reaction (RT-PCR) positive COVID-19 patients (n-322). Data about patient's age, gender, co-morbidities, duration of hospital and intensive care unit (ICU) stay, need for mechanical ventilation and laboratory investigations were obtained from the Hospital Information System (HIS). Results: The average duration of hospital stay was 10 days, and the ICU stay of these patients was 6.5 days. There was a statistically significant increase in C-reactive protein (CRP), ferritin, lactate dehydrogenase (LDH), aspartate aminotransferase (AST), neutrophils, and neutrophil/lymphocyte ratio (NLR), and lower mean lymphocytic count (p ¼ 0.05), in patients who required ICU admission when compared to those who didn't and also among non-survivors compared to survivors. Conclusion: Among the various biochemical & hematological markers, CRP, ferritin, LDH AST, and NLR were found to be better predictors of severity and mortality in COVID 19 patients. Timely monitoring of these markers would therefore help in better management and improved outcome for these patients.
International Journal of Health & Allied Sciences, 2022
Introduction: Coronavirus diseases (COVID-19), the global pandemic has posed a serious threat to the health of individuals across the world and is associated with increased morbidity and mortality. Several biochemical and hematological parameters are found to be altered in these patients and there is a need to identify a suitable biomarker that can help in better risk stratification of these patients. Hence in this study, we intend to evaluate the clinical utility of these parameters to predict severity and mortality in COVID-19 patients. Material & methods: A retrospective, observational study was conducted in a tertiary care hospital involving Reverse Transcription Polymerase Chain Reaction (RT-PCR) positive COVID-19 patients (n-322). Data about patient's age, gender, co-morbidities, duration of hospital and intensive care unit (ICU) stay, need for mechanical ventilation and laboratory investigations were obtained from the Hospital Information System (HIS). Results: The average duration of hospital stay was 10 days, and the ICU stay of these patients was 6.5 days. There was a statistically significant increase in C-reactive protein (CRP), ferritin, lactate dehydrogenase (LDH), aspartate aminotransferase (AST), neutrophils, and neutrophil/lymphocyte ratio (NLR), and lower mean lymphocytic count (p ¼ 0.05), in patients who required ICU admission when compared to those who didn't and also among non-survivors compared to survivors. Conclusion: Among the various biochemical & hematological markers, CRP, ferritin, LDH AST, and NLR were found to be better predictors of severity and mortality in COVID 19 patients. Timely monitoring of these markers would therefore help in better management and improved outcome for these patients.
Biochemical Markers Associated with COVID-19 Disease Severity in a Tertiary Care Teaching Hospital
Indian Journal of Medical Biochemistry
Aims and objectives: The coronavirus disease-2019 (COVID-19) pandemic has led to an urgent need for reliable biomarkers to identify disease severity. Infection with COVID-19 is rapidly spreading posing a serious threat to community health. This study aims to identify the most effective biomarker among C-reactive protein, procalcitonin, lactate dehydrogenase, and ferritin to predict disease severity. The routine biochemical markers (LFT, RFT, electrolytes, CKNAC, CKMB, blood glucose level) were also evaluated for correlation with disease severity. Materials and methods: The present study is retrospective type. The study protocol was approved by IEC. The levels of biochemical markers of admitted COVID-19 positive patients were analyzed after determining the normal distribution and their significance was determined by calculating the p value. The accuracy of the biomarkers [C-reactive protein (CRP), PCT, lactate dehydrogenase (LDH), and ferritin] was checked using ROC analysis. Results: Five hundred and ninety-one COVID-19 positive patients admitted to the hospital (from May 2020 to December 2020) were considered for the study. Out of these 231 (39.1%) were admitted to the intensive care unit (ICU) and 360 (61%) were inward patients. The mean age of the study population was 50.39 ± 16.7, with ICU patients significantly older than non-ICU patients (p < 0.001) and 50-75 years being the most common age group. There was a statistically significant difference in the values of CRP, LDH, PCT, ferritin, AST, albumin, urea, CKNAC, sodium, potassium, and blood glucose levels (p value < 0.05). Conclusion: The severity of COVID-19 disease can be identified at an early stage by following the different routine biochemical marker levels and subsequently improve prognosis. Inflammatory markers (CRP, PCT, LDH, and ferritin) serve as useful guidance for determining disease severity in COVID-19 patients.
INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH
Novel corona virus epidemic started in Dec 19 in Wuhan,China and soon it spread globally and became an international emergency Our objective was to study the role of hematological and biochemistry markers in assessing the disease severity and prognosis of laboratory confirmed,hospitalized Covid 19 patients.130 patients were included in this crosssectional retrospective study and divided into mild/moderate and severe/critical group.Correlation analysis was done for laboratory biomarkers.We found that mean age,lactate dehydrogenase (LDH),S.ferritin,urea,uric acid,D-dimer and S.creatinine of severely ill patients were significantly higher than those of patients with non-severe illness. Leucopenia and neutropenia were also associated with disease severity.Males were affected more than females with both mild and severe illness. Following parameters like S. Ferritin, LDH,TLC, neutrophil % can help in identifying the progression of disease from mild to severe and help in adopting appropria...
Predictive values of biochemical markers as early indicators for severe COVID-19 cases in admission
Future Virology, 2021
Aim: COVID-19 is a pandemic that causes high morbidity and mortality, especially in severe patients. In this study, we aimed to search and explain the relationship between biochemical markers, which are more common, easily available and applicable to diagnose and to stage the disease. Materials & methods: In this study, 609 patients were evaluated retrospectively. 11 biochemical parameters were included in analysis to explain the relationship with severity of disease. Results: Nearly, all the parameters that have been evaluated in this study were statistically valuable as a predictive parameter for severe disease. Areas under the curve of blood urea nitrogen (BUN)/albumin ratio (BAR), CALL score and lymphocyte/C-reactive protein ratio were 0.795, 0.778 and 0.770. The BUN/BAR and neutrophil/albumin ratios provide important prognostic information for decision-making in severe patients with COVID-19. Conclusion: High BUN/BAR and neutrophil/albumin ratios may be a better predictor of severity COVID-19 than other routinely used parameters in admission.
Journal of Clinical Medicine of Kazakhstan, 2021
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 cutoff 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.
Journal of Istanbul Faculty of Medicine / İstanbul Tıp Fakültesi Dergisi, 2022
Objective: Early detection of mortality risk is important in patients diagnosed with of coronavirus disease 2019 (COVID-19). Therefore, we aimed to evaluate the predictive value of different clinical and laboratory parameters in disease severity and mortality in patients with COVID-19. Materials and Methods: Patients admitted to hospital with a diagnosis of COVID-19 were evaluated retrospectively. The patients' admission date, discharge date, intensive care transfer/death date, contact history, smoking, symptoms at the time admission, vital markers at admission, and laboratory parameters were recorded. Results: The study included a total of 347 patients, of whom 168 (48.4%) were women. The mean age of the patients was 59.69 +/- 16.87 (14-97) years, while 40.9% (n=142) were aged over 65 years. Overall, 10.1% (n=35) of the patients required transfer to an intensive care unit and 8.4% (n=29) were deceased. When clinical parameters were evaluated at the time of admission, oxygen sat...
Journal of Universal College of Medical Sciences
INTRODUCTION Coronavirus disease has become a universal health problem and has resulted in millions of hospitalization and deaths. Coronavi- rus is a multi-system infection predominantly affecting the respiratory system, resulting in various hematological and biochemical alterations reflected in various investigations. Multitudes of research establishing the role of biomarkers in coronavirus infection are ongoing globally. This study aimed at studying the common biochemical markers like CRP, LDH, and D-dimer to access the severity of the disease and hospital outcome. MATERIAL AND METHODS This was a retrospective cross-sectional study performed at a tertiary care hospital in western Nepal among RT-PCR-positive ICU patients who were ≥ 18 years for a period of six months (May 1 to October 30, 2020). Demographic, clinical, and laborato- ry data were collected from hospital records and the results were analyzed. RESULTS Among 110 admitted patients, 56 were females and 54 were males. The m...
International journal of health sciences
Background: We used standard laboratory test to determine tissue injury and inflammatory state on the physiological condition of fever, cough, headache in 672 patients tested for CRP and 407 patients tested for LDH out of a total of 994 COVID-19 admissions during the period of April 2021-September 2021 at Parul Sevashram Hospital, Vadodara. The data was stratified based on the survivor/non-survivor status and severity of disease condition based on Ward or ICU admissions. The results were correlated with the vales of serum CRP and LDH levels for determining their prognostic significance. Patients and Methods: This is a retrospective, single-centre, observational study using the data collected from MRD division through electronic records and standardized data collection template. It included patients who were tested for CRP and LDH at times of admission. Mean, Standard deviation, Median and Interquartile range (IQR) were used to present continuous variables. Student’s t-test was used ...