CRP-Albumin Ratio Predicts in Hospital Survival of Infected COVID-19 Patient: Study in South Kalimantan, Indonesia
Abstract
Until the end of 2022, Indonesia had a case fatality rate (CFR) of 2.4% in COVID-19, higher than the global CFR of 1%. South Kalimantan, as one province in Indonesia, had CFR reached 2.9%. Improved treatment options and a better understanding of prognostic markers may reduce case fatality. Because of that, we decided to analyze CRP, albumin, and CRP-Albumin Ratio as prognostic markers in COVID-19. We conducted a retrospective study of 980 COVID-19 patients at Ulin Hospital Banjarmasin. The demographic data of the patients were analyzed and separated into two groups (survivors and non-survivors). We found that age, sex, and comorbidities such as hypertension, diabetes mellitus, and obesity correlated with mortality. CRP, albumin, and CRP-Albumin Ratio also correlated with mortality (p < 0.001) with an OR of 1.011, 0.468, and 1.032 respectively using univariate analysis. On multivariate analysis, we found that CRP, albumin, and CRP-Albumin Ratio are independent prognostic markers for mortality. ROC curve analysis shows that the CRP cut-off point was > 61,2 (sensitivity 70,2%, specificity 67,9%) with AUC 0.750 (p < 0.001) in predicting mortality. For the albumin, the cut-off point was < 3,25 (sensitivity 64,6%, specificity 54,1%) with AUC 0.628 (p <0.001). Furthermore, in the CAR, the cut-off point was > 26,2 (sensitivity 62,4%, specificity 77,7%) with AUC 0.753 (p <0.001). In conclusion, our study found that CRP, albumin, and CRP-Albumin ratio had a significant connection with mortality, with CRP-albumin ratio being a better predictor. It could be a substantial predictor of mortality in hospitalized COVID-19 patients, which is very easy and cheap.
Keywords: Covid-19, mortality, prognostic markers, CRP-albumin ratio, Indonesia.
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