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Factors Affecting Duration of Hospital Stay in Deceased COVID-19 Patients
Ercan Kurtipek1, Mehmet Mermer1, Bilgenur Yıldırım1
1Department of Chest Diseases, University of Health Sciences, Konya City Hospital, Karatay, Konya, Turkey.
Insights
Neutrophil-to-lymphocyte ratio (NLR) and CRP/albumin ratio (CAR) predict mortality in COVID-19 patients. Higher NLR and CAR levels indicate a higher risk of early death, suggesting their use in prognosis.
Area of Science:
- Medical Science
- Infectious Diseases
- Critical Care Medicine
Background:
- COVID-19 prognosis is crucial for patient management.
- Inflammatory markers like white blood cell count, C-reactive protein (CRP), CRP/albumin ratio (CAR), neutrophil-to-lymphocyte ratio (NLR), and ferritin are associated with increased inflammation.
- These markers may predict outcomes in COVID-19 patients.
Purpose of the Study:
- To investigate the predictive value of NLR, CAR, and other laboratory parameters for hospital stay duration and mortality in COVID-19 patients.
- To determine if NLR and CAR can predict early mortality within 10 days of hospitalization.
Main Methods:
- Retrospective analysis of 1516 hospitalized COVID-19 patients.
- Patients categorized into two groups: deceased within 10 days (Group I) and deceased after 10 days (Group II).
- Collected data included age, gender, time to mortality, neutrophil count, CRP, NLR, CAR, and d-dimer levels.
Main Results:
- NLR and CAR were significantly higher in patients who died within 10 days (p<0.02 and p<0.001, respectively).
- White blood cell count, neutrophils, CRP, and d-dimer levels were also significantly higher in the early mortality group (p<0.05).
- Logistic regression confirmed NLR and CAR as significant predictors, with calculated cut-off values of 5.74 and 4.27, respectively.
Conclusions:
- NLR and CAR may significantly influence hospital stay duration and mortality in fatal COVID-19 cases.
- Close monitoring of COVID-19 patients with diabetes is recommended due to potential disease severity.
Objective:
Extensive research has been conducted to identify the predictive criteria for COVID-19 disease. White blood cell, C-reactive protein, CRP/albumin ratio, neutrophil-to-lymphocyte ratio and ferritin are among the indicators of increased inflammatory response; hence, they could be used to determine the prognosis of COVID-19 cases. Within the scope of this study, we aimed to elucidate the predictivity of NLR, CAR and other laboratory parameters on the duration of hospital stay and mortality in patients with COVID-19.
Materials And Method:
The data of 1516 COVID-19 patients who were hospitalized in our institution have been analyzed retrospectively. Patients were divided into two groups those who deceased within the first 10 days of hospitalization (Group I, ≤10 days) and those who deceased in the later period (Group II, >10 days). Age, gender, time to mortality after hospitalization, neutrophil count, CRP, neutrophil-to-lymphocyte ratio (NLR), CRP/albumin ratio (CAR), and d-dimer values were obtained from blood samples taken during hospitalization.
Results:
NLR and CAR values were significantly higher in those who died in the first 10 days compared to the other group (p<0.02 and p<0.001, respectively). In addition, WBC, neutrophil, CRP and d-dimer levels were statistically significantly higher than the other group (p<0.05). Logistic regression analysis results for NLR and CAR were significant. The cut-off values were calculated (5.74 and 4.27, respectively) for both parameters. Among the most common comorbid diseases were hypertension (HT) in 41%, coronary artery disease (CAD) in 41.7%, asthma-chronic obstructive pulmonary disease (COPD) in 36.7%, diabetes mellitus (DM) in 36.1%.
Conclusion:
NLR and CAR may have a decisive influence in determining the length of stay in hospital for patients who die in hospital due to COVID-19. In addition, it is recommended that COVID-19 cases with diabetes be followed closely.
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