Assessment of Neutrophil to Albumin Ratio and C-reactive Protein with the Mortality in Patients with COVID-19 in Medical City Complex

Abstract

Background: Coronavirus disease 2019 (COVID-19) is a new viral disease that affected multiple
organs in the body.
Aims: to investigate the role of neutrophil count to albumin ratio (NAR) and serum level of C-reactive
protein (CRP) in predicting mortality in patients with COVID-19.
Patients and Methods: This was a prospective study including 100 patients with SARS-CoV-2.
Patients demographics (age and gender) were collected through direct interview. Laboratory
parameters (total white blood cell count, absolute neutrophil count, hemoglobin concentration, serum
albumin, CRP titer, CT scan findings were gathered from patient’s records. The neutrophil albumin
ratio (NAR) was calculated by dividing the absolute neutrophil count by serum albumin concentration.
Patients were followed-up for one month.
Results: Mortality rate was 53%. The mean age of the survivors and non- survivors was 44.72±16.71
years and 51.04±12.87 years, respectively with a significant difference. 83.02% of non-survivors had
sever lung lesion compared with only 31.91% of survivors who had such lesions. The median NAR
and CRP in non-survival patients was 450 and 175 mg/L, respectively compared with 246.5 and 140
mg/L, respectively in survivors with highly significant differences. The sensitivity and specificity of
CRP in predicting mortality were 59% and 60%, respectively, at a cut-off value of 55.5 mg/L, while
the sensitivity and specificity of NAR were 80% for both, at a cut-off value of 358.85.
Conclusions: Inflammatory markers including CRP, are significantly associated with high mortality
rate. The neutrophil albumin ratio showed a significant association with mortality with a sensitivity and
specificity of 80% for both, at a cut-off value of NAR = 358.85.