C-reactive protein and albumin association with mortality of hospitalised SARS-CoV-2 patients: A tertiary hospital experience

Clin Med (Lond). 2020 Sep;20(5):463-467. doi: 10.7861/clinmed.2020-0424.

Abstract

Objective: The objective was to study hospitalised COVID-19 patients' mortality and intensive care unit (ICU) admission with covariates of interest (age, gender, ethnicity, clinical presentation, comorbidities and admission laboratory findings).

Methods: Logistic regression analyses were performed for patients admitted to University Hospital, University Hospitals Coventry and Warwickshire NHS Trust, between 24 January 2020 - 13 April 2020.

Results: There were 321 patients hospitalised. Median age was 73 years and 189 (59%) were male. Ethnicity was divided between Caucasian (77%), and black, Asian, and minority ethnic (BAME) groups (23%). Commonest symptoms were dyspnoea (62.9%), fever (59.1%) and cough (56%). Gastrointestinal symptoms amounted to 11.8%.Forty-four patients (13.7%) received ICU care. ICU male to female ratio was 3:1 (p=0.027; odds ratio (OR) 2.3; 95% confidence interval (CI) 1.1-4.9), BAME (p=0.008; OR 2.5; 95% CI 1.3-4.9), age >65 years (p=0.026; OR 0.28; 95% CI 0.09-0.93), heart disease (p=0.009; OR 0.2; 95% CI 0.1-0.6) and elevated C-reactive protein (CRP; p<0.001; OR 1.004; 95% CI 1.002-1.008) were associated with ICU admission.One-hundred and four patients (32.4%) died. Age >65 years (p=0.011; OR 5; 95% CI 1.6-21.9), neutrophils (p=0.047), neutrophil:lymphocyte ratio (NLR; p=0.028), CRP (p<0.001) and albumin (p=0.002) were associated with mortality. When analysis adjusted for age, CRP (p<0.001; OR 1.006; 95% CI 1.004-1.008) and albumin (p=0.005; OR 0.94; 95% CI 0.90-0.98) remained associated with mortality.

Conclusions: COVID-19 has high mortality. BAME and male patients were associated with ICU admission. High CRP and low albumin (after correcting for age) were associated with mortality.

Keywords: C-reactive protein; COVID-19; SARS-CoV-2; albumin; mortality.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Albumins / metabolism*
  • C-Reactive Protein / metabolism*
  • COVID-19
  • Cause of Death*
  • Coronavirus Infections / blood*
  • Coronavirus Infections / mortality*
  • Coronavirus Infections / physiopathology
  • Female
  • Geriatric Assessment
  • Hospital Mortality / trends*
  • Hospitalization / statistics & numerical data
  • Hospitals, University
  • Humans
  • Intensive Care Units / statistics & numerical data
  • Logistic Models
  • Male
  • Odds Ratio
  • Pandemics
  • Pneumonia, Viral / blood*
  • Pneumonia, Viral / mortality*
  • Pneumonia, Viral / physiopathology
  • Retrospective Studies
  • Risk Assessment
  • Severity of Illness Index
  • Tertiary Care Centers
  • United Kingdom

Substances

  • Albumins
  • C-Reactive Protein