Predictivity of CRP, Albumin, and CRP to Albumin Ratio on the Development of Intensive Care Requirement, Mortality, and Disease Severity in COVID-19

Background: The C-reactive protein (CRP) to albumin ratio (CAR) is a new index calculated by dividing CRP by the albumin level. It has been claimed to have predictive value in determining morbidity and mortality in many critical diseases Aim: In this research, we aimed to elucidate the importance of CRP, albumin, and CAR as parameters that can predict the clinical course in COVID-19 patients. Materials & method: In this retrospective analysis, the clinical, laboratory, and radiological findings of patients over the age of 18 who were diagnosed with SARS-CoV-2 infection with a positive reverse transcription-polymerase chain reaction (RT-PCR) test were evaluated. Age, gender, laboratory examinations at admission, and CRP and albumin values at the time of diagnosis have been recorded. The relationship of these parameters with the requirement for intensive care, exitus, and serious illness in the clinical follow-up of the patients was investigated. The baseline hospitalization parameters of the patients were compared between the severe and non-severe groups. Results: Individuals with severe disease had a higher rate of additional disease than those with non-severe disease. It was observed that the mean laboratory values ​​of patients with severe disease had a statistically higher level of D-dimer, CRP, aspartate aminotransferase (AST), platelet distribution width (PDW), CRP-albumin ratio, and ferritin, compared to mild to moderate cases (p<0.05). The rate of additional disease in deceased patients was higher than in patients who were alive (p<0.05). The CAR value was found to be moderately predictive in our study revealing the severity of the disease, and the possibility that the severity of the disease might be higher in patients with a CAR value above 21.47. Conclusion: The results of this study revealed that CAR is a potential parameter in distinguishing critically ill COVID-19 patients in need of intensive care. Therefore, one can say that CAR is an important biomarker in clinically determining COVID-19.