The Predictive Ability of the C-reactive Protein to Albumin Ratio As A Mortality Predictor in Hospitalized Severe SARS-CoV-2 Infected Patients with Cardiovascular Diseases

Aim: Although there are few studies on the predictive value of C-reactive protein-to-albumin ratio (CAR) in coronavirus disease-2019 (COVID-19) patients, to the best of our knowledge, there are no studies specifically conducted in COVID-19 patients with cardiovascular disease (CVD). This study assessed the use of baseline CAR levels to predict death in hospitalized COVID-19 patients with CVD. Methods: This study was designed as a single-center cross-sectional study. Patients diagnosed with COVID-19 who were admitted to the University of Health Sciences Turkey, Bagcilar Training and Research Hospital between April 16 and May 20, 2020 were analyzed retrospectively. The patients were divided into 2 groups: those who died and those who survived, considering the follow-up period. The CAR values of the study population, as well as patients with CVD, were calculated, and the association of CAR with in-hospital mortality was evaluated. Results: The in-hospital mortality rate was 11.1% (49/442 pts) in all populations. Deceased patients had significantly more frequent CVD (p<0.001) and the mortality rate was 34.4% (30/96 pts) in those patients. Median CAR values were higher in nonsurvivors than among survivors (p<0.001). Multivariate analysis demonstrated that CAR was an independent predictor of mortality in patients with CVD [hazard ratio 1.013 (95% confidence interval: 1.002-1.022), p=0.018]. Conclusion: CAR is an inflammatory risk marker that independently predicts mortality in all COVID-19 hospitalized patients and patients with CVD.

Immature platelet fraction: Is a novel early predictive marker for disease severity in patients with Covid-19 pneumonia?

Objectives: In many diseases, immature platelet fraction (IPF%) is related to coagulopathy and poor outcome. This study aimed to investigate the predictive value of IPF% for the severity of pneumonia in patients with Coronavirus Disease 2019 (COVID-19). Methods: A total of 154 patients with COVID-19 infections were included. The patients were divided into two groups according to the severity of pneumonia (severe and nonsevere) regarding their oxygen demand. Results: Given laboratory parameters, themedian IPF% was significantly higher in the severe group (11.9 vs. 3.9%, p<0.001). Mean platelet volume (p<0.001), platelet-large cell ratio (p=0.001), platelet distribution width (p=0.001),D-Dimer (p<0.001), INR (p=0.003), and aPTT (p=0.007) were also found to be significantly higher in the severe group.Moreover, IPF (p=0.014, Odds ratio = 2.000, 95%CI: 1.149-3.482) was an independent predictor for the severity. The curve value from receiver operating characteristics was 0.879 (p<0.001, 95%CI: 0.784-0.943) for determining the severity of pneumonia. IPF% had a sensitivity and specificity value of 69.5 and 92.4% to detect the disease's severity. Conclusions: IPF% is an independent predictor for the severity of COVID-19 pneumonia. Assessment of IPF% may both help to early determine high-risk patients with COVID-19 and to alert the physicians.