Prognostic significance of inflammatory scoring systems in critically ill patients with COVID-19 infection

Aim: The outbreak of novel coronavirus pneumonia that was first detected in Wuhan in December 2019 resulted in a worldwide pandemic. Approximately 25% of confirmed cases developed a severe disease and the need for intensive care unit admission. The aim of this study was to determine the role of three inflammatory scoring systems, C-reactive protein/albumin ratio, fibrinogen/albumin ratio, C-reactive protein/lymphocyte ratio and their association with survival, comorbidities, and the occurrence of additional complications in the intensive care of these patients. Materials and methods: This retrospective study was conducted based on data collected by the Department of Respiratory Center. Ethical approval for the study was obtained from the Ethics Committee of Osijek University Hospital. This study analysed data retrospectively between October and December 2020, and included 137 critically ill patients with a diagnosis of COVID-19. Results: Data analysis of three examined inflammatory points of the system, below and above the median found a significant association in the group below the median C-reactive protein/albumin ratio with the presence of complications (p= 0,039) in the group above the median in the study of fibrinogen/albumin ratio found a significant association with sepsis (p=0,043). In the group of participants who were above its median in terms of C-reactive protein/lymphocyte ratio, there were more of those with the development of acute kidney injury (p=0,014), and sepsis (p=0,009). Conclusion: Inflammatory scoring systems, C-reactive protein/albumin ratio, fibrinogen/albumin ratio and C‐reactive protein/lymphocyte ratio represent an independent prognostic indicator of the clinical course in critically ill patients with COVID-19 infection.