Uzum Yusuf, Turkkan Ebru
Internal Medicine, Katip Celebi University, Ataturk Training and Research Hospital, Izmir, TUR.
Cureus. 2023 Jan 10;15(1):e33600. doi: 10.7759/cureus.33600. eCollection 2023 Jan.
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.
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.
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.
C反应蛋白（CRP）与白蛋白比值（CAR）是通过将CRP除以白蛋白水平计算得出的新指标。据称，它在许多重症疾病的发病率和死亡率判定中具有预测价值。目的：在本研究中，我们旨在阐明CRP、白蛋白和CAR作为预测COVID-19患者临床病程参数的重要性。
在这项回顾性分析中，对18岁以上经逆转录聚合酶链反应（RT-PCR）检测确诊为SARS-CoV-2感染的患者的临床、实验室和影像学检查结果进行了评估。记录了患者的年龄、性别、入院时的实验室检查以及诊断时的CRP和白蛋白值。研究了这些参数与患者临床随访中重症监护需求、死亡和重症疾病的关系。比较了重症组和非重症组患者的基线住院参数。
重症患者的合并症发生率高于非重症患者。观察到，与轻至中度病例相比，重症患者的平均实验室值在D-二聚体、CRP、天冬氨酸转氨酶（AST）、血小板分布宽度（PDW）、CRP-白蛋白比值和铁蛋白方面具有统计学上更高的水平（p<0.05）。死亡患者的合并症发生率高于存活患者（p<0.05）。在我们的研究中发现，CAR值对疾病严重程度具有中度预测性，且CAR值高于21.47的患者疾病严重程度可能更高。
本研究结果表明，CAR是区分需要重症监护的重症COVID-19患者的潜在参数。因此，可以说CAR是临床上判定COVID-19的重要生物标志物。
