To examine the role of d-dimer/fibrinogen, CRP/albumin, procalcitonin/albumin, fibrinogen/albumin and D-dimer/albumin ratios of patients followed in the intensive care unit in predicting the mortality and prognosis of COVİD 19

Introduction: In this study, it was aimed to predict the first-day mortality and prognosis of patients admitted to the Intensive Care Unit with the diagnosis of Covid-19, and to determine whether D-Dimer/Fibrinogen ratio(DFR), CRP/Albumin ratio(CAR), Procalcitonin/Albumin ratio(PAR), Fibrinogen/Albumin ratio(FAR) or D-Dimer/Albumin ratio(DAR); It was aimed to determine whether it is a more accurate predictor of mortality and prognosis compared to D-Dimer, Fibrinogen, CRP, Procalcitonin, Albumin levels. MaterialsandMethods: This study is a retrospective and descriptive study conducted on patients admitted to the Intensive Care Unit (ICU) of Adıyaman University Adıyaman Training and Research Hospital between 01/09/2020 and 28/02/2021 due to Covid-19. It is a hospital-based, single-center, retrospective study and data were obtained in the form of file scanning. Patients' age, gender, SARS-CoV-2 RT-PCR test results, length of stay, whole blood parameters measured on the first day of admission to the ICU, CRP, D-dimer, fibrinogen, procalcitonin, albumin levels, comorbid diseases of the patients and hospitalization Mortality cases were recorded. Findings: 155 patients were included in the study. While 40.6% (n=63) of the patients were female, 59.4% (n=92) were male. The mean age of the patients was 72.39±12.19. The mean age of female patients was 75.16±10.55, and the mean age of male patients was 70.49±12.92. The length of stay of the patients in the intensive care unit was 9.94±6.95. The mean length of hospitalization for female patients was 9.92±6.66, and the mean duration of hospitalization for male patients was 9.95±7.17. Considering the general mortality rates of the patients, exitus letalis occurred in 71.0% (n=110). While exitus letalis occurred in 74.6% (n=47) of female patients, exitus letalis occurred in 68.5% (n=63) of male patients. CRP, Fibrinogen, Procalcitonin, CRP/Albumin ratio, Procalcitonin/Albumin ratio, Fibrinogen/Albumin ratio, D-dimer, D-Dimer/Albumin ratio, which are the biomarkers used to evaluate the prognosis of the patients, were statistically significantly higher in the patients who died. In the ROC analysis, it was determined that CAR (AUC: 0.686, 95% CI 0.585-0.787, p<0.0001) had the highest predictive power among the predictive values determined by the area under the curve. If the cut-off value of the CRP/Albumin ratio was 4.65 the sensitivity was 60% and the specificity was 75.6%. The highest AUC value after CAR; The sensitivity of CRP was (AUC: 0.683, 95% CI 0.581-0.784, p<0.0001) and the cut-off value was 8.2, while the sensitivity was 80% and the specificity was 51.1%. The highest AUC value after CRP was PAR (AUC: 0.659, 95% CI 0.570-0.749, p=0.002), and the sensitivity was found to be 51.8%, specificity 75.6%, when the cut-off value was taken as 0.19 to predict mortality. Conclusion: According to the study data, CAR, CRP, and PAR were found to be the highest predictors of mortality in patients admitted to the intensive care unit, respectively. We concluded that these markers can guide the clinician in the evaluation of in-hospital mortality.