Giner-Galvañ Vicente, Pomares-Gómez Francisco José, Quesada José Antonio, Rubio-Rivas Manuel, Tejada-Montes Javier, Baltasar-Corral Jesús, Taboada-Martínez María Luisa, Sánchez-Mesa Blanca, Arnalich-Fernández Francisco, Del Corral-Beamonte Esther, López-Sampalo Almudena, Pesqueira-Fontán Paula María, Fernández-Garcés Mar, Gómez-Huelgas Ricardo, Ramos-Rincón José Manuel
Department of Internal Medicine, Hospital Clínico Universitario San Juan de Alicante, 03550 Alicante, Spain.
Fundación para el Fomento de la Investigación Sanitaria y Biomédica (FISABIO), 46020 Valencia, Spain.
Biomedicines. 2022 Jun 13;10(6):1393. doi: 10.3390/biomedicines10061393.
(1) Background: C-reactive protein (CRP) and albumin are inflammatory markers. We analyzed the prognostic capacity of serum albumin (SA) and CRP for an outcome comprising mortality, length of stay, ICU admission, and non-invasive mechanical ventilation in hospitalized COVID-19 patients. (2) Methods: We conducted a retrospective cohort study based on the Spanish national SEMI-COVID-19 Registry. Two multivariate logistic models were adjusted for SA, CRP, and their combination. Training and testing samples were used to validate the models. (3) Results: The outcome was present in 41.1% of the 3471 participants, who had lower SA (mean [SD], 3.5 [0.6] g/dL vs. 3.8 [0.5] g/dL; p < 0.001) and higher CRP (108.9 [96.5] mg/L vs. 70.6 [70.3] mg/L; p < 0.001). In the adjusted multivariate model, both were associated with poorer evolution: SA, OR 0.674 (95% CI, 0.551−0.826; p < 0.001); CRP, OR 1.002 (95% CI, 1.001−1.004; p = 0.003). The CRP/SA model had a similar predictive capacity (honest AUC, 0.8135 [0.7865−0.8405]), with a continuously increasing risk and cutoff value of 25 showing the highest predictive capacity (OR, 1.470; 95% CI, 1.188−1.819; p < 0.001). (4) Conclusions: SA and CRP are good independent predictors of patients hospitalized with COVID-19. For the CRP/SA ratio value, 25 is the cutoff for poor clinical course.
(1) 背景：C反应蛋白（CRP）和白蛋白是炎症标志物。我们分析了血清白蛋白（SA）和CRP对住院COVID-19患者包括死亡率、住院时长、入住重症监护病房（ICU）以及无创机械通气在内的预后情况的预测能力。(2) 方法：我们基于西班牙国家SEMI-COVID-19登记处进行了一项回顾性队列研究。针对SA、CRP及其组合调整了两个多变量逻辑模型。使用训练样本和测试样本对模型进行验证。(3) 结果：在3471名参与者中，41.1%出现了该预后情况，这些患者的SA较低（均值[标准差]，3.5[0.6]g/dL vs. 3.8[0.5]g/dL；p<0.001）且CRP较高（108.9[96.5]mg/L vs. 70.6[70.3]mg/L；p<0.001）。在调整后的多变量模型中两者均与较差的病情进展相关：SA，比值比（OR）0.674（95%置信区间[CI]，0.551 - 0.826；p<0.001）；CRP，OR 1.002（95%CI，1.001 - 1.004；p = 0.003）。CRP/SA模型具有相似的预测能力（真实曲线下面积[AUC]，0.8135[0.7865 - 0.8405]），风险持续增加，截断值为25时显示出最高的预测能力（OR，1.470；95%CI，1.188 - 1.819；p<0.001）。(4) 结论：SA和CRP是住院COVID-19患者良好的独立预测指标。对于CRP/SA比值，25是临床病程不佳的截断值。
