Department of Emergency, University of Health Sciences, Beyhekim Training and Research Hospital, Konya, Turkey.
Eur Rev Med Pharmacol Sci. 2023 Jul;27(13):6429-6436. doi: 10.26355/eurrev_202307_33003.
The aim of the present study was to investigate the relationship between albumin, blood urea nitrogen (BUN)/albumin ratio (BAR), D-dimer/albumin ratio (DAR), C-reactive protein (CRP)/albumin ratio (CAR), and neutrophil/albumin ratio (NAR) levels and prognosis in severe COVID-19 cases.
A total of 619 patients diagnosed with severe COVID-19 in the emergency department were retrospectively analyzed. BAR, DAR, CAR, and NAR values were obtained by dividing BUN, neutrophil, CRP, and D-dimer by albumin. All patients were divided into groups [survived and deceased patients, and those who received and did not receive mechanical ventilation (MV) assistance]. These groups were statistically compared with regard to albumin, BAR, DAR, CAR, and NAR.
While 350 out of 619 patients survived, 269 patients died. A statistically significant difference was determined between survived and deceased patient groups with regard to BUN, neutrophil, lymphocyte, CRP, D-dimer, albumin, BAR, NAR, DAR, and CAR levels (p<0.001 for all). Also, BAR, NAR, DAR, and CAR were significantly higher in those who received MV support, while albumin was found to be low (p<0.001). According to receiver operating characteristic (ROC) analysis, NAR, BAR, CAR, albumin, and DAR had the highest area under the curve (AUC) values compared to the other parameters (0.825, 0.815, 0.806, 0.772, and 0.770, respectively) (p<0.001 for all). According to logistic regression analysis, BAR, NAR, DAR, and CAR levels were determined as important risk factors for mortality.
Low serum albumin levels can be used for severity as an additional tool in severe COVID-19 patients. Moreover, the NAR, BAR, and CAR levels were found to be more valuable than albumin levels in predicting prognosis in these patients.
本研究旨在探讨血清白蛋白、血尿素氮/白蛋白比值（BAR）、D-二聚体/白蛋白比值（DAR）、C 反应蛋白/白蛋白比值（CAR）和中性粒细胞/白蛋白比值（NAR）水平与重症 COVID-19 患者预后的关系。
回顾性分析了急诊科诊断为重症 COVID-19 的 619 例患者。通过将 BUN、中性粒细胞、CRP 和 D-二聚体除以白蛋白，得出 BAR、DAR、CAR 和 NAR 值。将所有患者分为存活组和死亡组，以及接受和未接受机械通气（MV）支持的组。统计比较各组间白蛋白、BAR、DAR、CAR 和 NAR 的差异。
619 例患者中，350 例存活，269 例死亡。存活组和死亡组在 BUN、中性粒细胞、淋巴细胞、CRP、D-二聚体、白蛋白、BAR、NAR、DAR 和 CAR 水平上有统计学差异（均 p<0.001）。同时，接受 MV 支持的患者 BAR、NAR、DAR 和 CAR 显著升高，而白蛋白水平降低（均 p<0.001）。根据受试者工作特征（ROC）分析，NAR、BAR、CAR、白蛋白和 DAR 的曲线下面积（AUC）值均高于其他参数（分别为 0.825、0.815、0.806、0.772 和 0.770，均 p<0.001）。Logistic 回归分析显示，BAR、NAR、DAR 和 CAR 水平是死亡的重要危险因素。
低血清白蛋白水平可作为重症 COVID-19 患者严重程度的附加工具。此外，NAR、BAR 和 CAR 水平在预测这些患者预后方面比白蛋白水平更有价值。
