C-reactive Protein, Albumin, Urea, CRP/Albumin Ratio, and Urea/Albumin Ratio: A Retrospective Evaluation in COVID-19 Patients
https://doi.org/10.47836/mjmhs.19.6.22
- Author:
Nor Amirah Mohammad Nazri
1
;
Wan Norlina Wan Azman
1
;
Norsyuhadah Musa
1
;
Tuan Salwani Tuan Ismail
1
;
Azian Harun
2
;
Najib Majdi Yaacob
3
;
Sarina Sulong
4
;
Sirajudeen K.N.S
5
;
Mahaya Che Mat
6
;
Hani Ajrina Zulkeflee
7
;
Siti Sarah Mustapa
8
Author Information
1. Department of Chemical Pathology, School of Medical Sciences, Universiti Sains Malaysia (Health Campus) Kelantan, Malaysia
2. Department of Medical Microbiology and Parasitology, Universiti Sains Malaysia (Health Campus) Kelantan, Malaysia
3. Unit of Biostatistic and Research Methodology, Universiti Sains Malaysia (Health Campus) Kelantan, Malaysia
4. Human Genome Centre, Universiti Sains Malaysia (Health Campus) Kelantan, Malaysia
5. Department of Basic Medical Sciences, Kuliyyah of Medicine, International Islamic University Malaysia, Kuantan Campus, Malaysia
6. Department of Pathology, Hospital Raja Perempuan Zainab II, Kelantan, Malaysia
7. Department of Medical Sciences II, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia
8. Department of Pathology, Hospital Ampang, Selangor, Malaysia
- Publication Type:Journal Article
- Keywords:
COVID-19;
c-reactive protein;
albumin;
urea;
CRP/albumin ratio;
urea/albumin ratio
- From:Malaysian Journal of Medicine and Health Sciences
2023;19(No.6):164-170
- CountryMalaysia
- Language:English
-
Abstract:
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.
- Full text:11.2023my1676.pdf
