The Prognostic Capabilities of Positive Acute Phase Reactants in Stratifying Hospitalized Covid-19 Infected Patients

Background/Aim: Several biochemical parameters in mechanically ventilated intensive care unit severe acute respiratory syndrome conronavirus-2 (MVICU-SARS-CoV-2) are strongly correlated with affected COVID-19 patients’ clinical outcomes. Of particular, C-reactive protein (CRP) and ferritin (FER) levels are commonly used in clinical practices for theirs diagnostic and prognostic performances. So, in this study we aimed to explore the two tested positive acute-phase reactants prognosticating capabilities in MVICU-affected COVID-19 patients. Methods: A single-center study was retrospectively processed for eligible admitted MVICU-SARS-CoV-2 infected patients between March 2020 and September 2021. One-Sample and Independent T-Tests were conducted to analyze parametric data while in contrary, Mann Whitney-U and Chi Square Tests were conducted to analyze non-parametric data. A Receiver Operating Characteristic Test followed by Sensitivity Analysis were also conducted to plot the area of each tested prognosticator and to pick the operating optimal dichotomous levels with their corresponding sensitivity indices. Results: Overall 28-day ICU mortality was detected in 94 (48.70%) during an average of 12.40±4.79 days of ICU length of stay. The whole study cohort mean age was 58.37±9.96 years. and the Non-Survivors Cohort were insignificantly younger than the Survivors Cohort (58.09±10.05 years vs 58.55±9.95 years, respectively, p>0.05). Significantly, males were distributed in the study in approximately a 2: 1 ratio compared to females. Biochemically, the c-reactive protein and ferritin were significantly higher in the Non-Survivors Cohort than in the Survivors Cohort [143.09±59.28 mg/dl and 891.51±377.82 ng/ml vs 88.38±34.38 mg/dl and 465.76±154.07 ng/ml, respectively, p LESS THAN 0.05]. Conclusion: In global ever-shrinking in medical teams and facilities, elevated levels of CRP and FER can be potentially used for their reasonable performances and prognostic utilities in early risk stratification and clinical trending tracking in MVICU-SRAS-CoV-2 infected patients. Both tested biochemical prognosticators may facilitate in optimum resource provision and swift management protocols implementation.