C-reactive Protein, Albumin, Urea, CRP/Albumin Ratio, and Urea/Albumin Ratio: A Retrospective Evaluation in COVID-19 Patients

@#Introduction: C-reactive protein (CRP), urea, albumin, CRP/albumin ratio (CAR) and urea/albumin ratio (UAR) could be valuable biomarkers for determining the severity of illness in patients with COVID-19. This study aimed to determine the association between these markers and disease severity in COVID-19 patients on admission and days five to seven after admission. Methods: This retrospective study includes 153 adult COVID-19 patients admitted to Hospital Raja Perempuan Zainab II and Hospital Ampang from January 2021 to December 2021. Patients’ serum CRP, urea, albumin and creatinine levels were recorded on admission and on days five to seven after admission. The patients were categorised based on the Annex 2e guidelines published by the Ministry of Health, Malaysia and further classified as mild to moderate disease (stages 1-3) and severe to critical illness (stages 4-5). Results: On admission, urea, creatinine, CRP, UAR and CAR were significantly higher in the severe to critical group (p<0.001). The optimal cut-off value for the UAR was 0.16; the area under the curve (AUC) was 0.760, and sensitivity and specificity were 63.6% and 85.7%, respectively. The AUC of the CAR was 0.752, with 54.2% sensitivity and 91.4% specificity at an optimal cut-off value of 1.63. In severe to critical COVID-19 patients, albumin levels decreased significantly on days five to seven after admission, while urea levels remained significantly higher in this group (p<0.001, p<0.05, respectively). Conclusion: CRP, urea, albumin, CAR and UAR are promising biomarkers for predicting the severity of disease in COVID-19 patients.

Ethnic difference in serum antibodies to oxidized low density lipoprotein in healthy Malaysian subjects.

Background: Some populations are more susceptible to atherosclerotic diseases than others. Indians had a higher mortality due to coronary heart disease (CHD) than Chinese and Malays. Antibodies to oxidized low density lipoprotein (Ab-oxLDL) are produced as an immune response to oxidized low density lipoprotein (oxLDL). The difference in prevalence of CHD among the ethnic groups may be related to the immune response. The objectives of this study were to determine the serum Ab-oxLDL levels and lipid profile among the three major Malaysian ethnic groups. Methods: The participants of this study were 150 healthy subjects consisting of 50 Malays, 50 Chinese and 50 Indians. Serum Ab-oxLDL was measured by enzyme immunoassay method. Serum triglycerides and total cholesterol were measured by enzymatic methods. Serum high density lipoprotein cholesterol (HDL-C) was measured by precipitation method and low density lipoprotein cholesterol (LDL-C) was calculated using Friedewald formula. Results: AboxLDL level [adjusted mean (95% of CI)] was highest in Malays [1404 (1202-1607) mU/mL] followed by Chinese [1026 (829-1223) mU/mL] and Indians [954 (744-1163) mU/mL] (P = 0.006) and HDL-C level was highest in Chinese [1.53 (1.44-1.61) mmol/L] followed by Malays [1.44 (1.35-1.53) mmol/L] and Indians [1.35 (1.26-1.45) mmol/L] (P = 0.035). Conclusion: Our results indicate that Ab-oxLDL and HDL-C levels differed by ethnic and AboxLDL may have antiatherogenic properties among Malaysian ethnic groups.