Prognostic value of ANDC score and CRP-derived inflammatory markers in hospitalized adult patients with COVID-19
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- a
- Clinical Hematology Unit, Internal Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
- b
- Internal Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
- c
- Tropical Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
- d
- Chest Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
- e
- Family Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
- f
- Clinical Pathology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
- g
- Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
- h
- Gastroenterology and Hepatology Unit, Internal Medicine Department, Faculty of Medicine, Zagazig University, Egypt
- i
- Department of Materials, Imperial College London, London, SW7 2AZ, United Kingdom
- j
- Department of Botany and Microbiology, College of Science, King Saud University, Saudi Arabia
Background:
SARS-CoV-2 has been a causative agent of severe acute respiratory syndrome since 2019. Early diagnosis of severe cases is crucial to decrease a patient's hospital stay and death risk. Severity and prognosis
Patients and Methods:
This retrospective study included COVID-19 patients who underwent chest computed tomography scan and a battery of laboratory tests, including measurements of leukocytes, neutrophils, lymphocytes, lactic dehydrogenase, creatinine level, ferritin, D-dimer, albumin, and C-reactive protein. In addition, the CRP to lymphocyte ratio (CLR), CRP to albumin ratio (CAR), CRP to platelet ratio (CPR), and the ANDC score. Patients' clinical outcomes were recorded, including length of hospital stays (LOS) and mortality.
Results:
Out of 98 patients, 51 patients had passed away. There was a statistically significant difference between survivors and non-survivors regarding age, TLC, ANC, NLR, D-Dimer, and albumin. Moreover, a highly statistically significant difference regarding CRP levels, CAR, CPR, CLR, and ANDC was noted. Serum CRP level > 123 ng/ml, CAR > 36.77, CPR level > 462, and CLR > 84 had sensitivity (64.71 %, 66.6 %, 72.5 %, and 76.4 %, respectively) and specificity (85.1 %, 78.7 %, 72.3 %, and 72.3 % respectively) in mortality prediction. Meanwhile, the ANDC score was the most sensitive indicator (88.2 %) for mortality outcomes. Multivariable regression analysis revealed that aging, CPR, and ANDC level were independently associated with mortality with H.R. [1.025 (1.002–1.050); 2.338 (1.189–4.599) and 2.896 (1.191–7.044)]
Conclusion:
The value of the ANDC score and CRP-derived inflammatory indicators correlate with the likelihood of mortality, so the efficacy of these metrics might assist in urgent early dialogues about treatment escalation.
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