The role of serum inflammatory markers, albumin, and hemoglobin in predicting the diagnosis in patients admitted to the emergency department with a pre-diagnosis of COVID-19

Akman, Canan; Bakırdöğen, Serkan

doi:10.1590/1806-9282.67.Suppl1.20200917

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Revista da Associação Médica Brasileira

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Original Article • Rev. Assoc. Med. Bras. 67 (Suppl 1) • 2021 • https://doi.org/10.1590/1806-9282.67.Suppl1.20200917 copy

The role of serum inflammatory markers, albumin, and hemoglobin in predicting the diagnosis in patients admitted to the emergency department with a pre-diagnosis of COVID-19

Authorship SCIMAGO INSTITUTIONS RANKINGS

SUMMARY

OBJECTIVE:

Serum inflammatory markers and albumin levels provide an assumption for the severity of COVID-19 infection. Our objective was to investigate the determinant role of serum inflammatory markers, albumin, and hemoglobin (Hb) in predicting the diagnosis in patients with a pre-diagnosis of COVID-19.

METHODS:

Demographic findings, complete blood count and serum biochemical values of the patients analyzed.

RESULTS:

Of the patients included in the study, 48 were COVID (+) and 253 were COVID (-). Statistically significant difference was found in terms of hemoglobin, mean platelet volume, and monocyte/eosinophil ratio.

CONCLUSIONS:

The levels of serum albumin, hemoglobin, monocyte/eosinophil ratio, and mean platelet volume can be predictive factors for diagnosis in patients with COVID-19.

KEYWORDS:
Hypoalbuminemia; Hemoglobins; Mean platelet volume; Monocytes; Eosinophils; Coronavirus infections; Emergency service, hospital

Groups		Gender		Total	χ²	SD	P^* P*: Chi-Square Test;
Groups		Female	Male	Total	χ²	SD	P^* P*: Chi-Square Test;
COVID (-)	f	99	154	253	2.794	1	0.095
	for COVID diagnosis%	39.1	60.9	100
	for Gender %	79.8	87.0	84.1
COVID (+)	f	25	23	48
	for COVID diagnosis %	52.1	47.9	100
	for Gender %	20.2	13.0	15.9%
		n	Mean (Standard Deviation)		Median (Min–Max)		P^ P: Mann Whitney U Test; SD: Standard deviation.
Age	COVID (-)	253	54.58 (21.54)		57 (19–92)		0.878
Age	COVID (+)	48	55.69 (16.81)		54 (22–93)		0.878

		N	Mean (SD)	Median (Min–Max)	P
MPV	COVID (-)	253	8.59 (1.016)	8.5 (6.7–12)	0.009
MPV	COVID (+)	48	8.25 (1.26)	8.1 (6.3–13.6)	0.009
NLR	COVID (-)	253	8.24 (13.05)	3.9 (0.03–133.0)	0.886
NLR	COVID (+)	48	6.95 (7.89)	4.4 (0.70–39.5)	0.886
PLR	COVID (-)	253	24.19 (40.53)	12.9 (2.30–470.0)	0.524
PLR	COVID (+)	48	21.1 (23.7)	15.10 (2.70–158.0)	0.524
Leukocyte (mm³)	COVID (-)	253	10196.4 (4883.1)	9200 (2700–44300)	0.153
Leukocyte (mm³)	COVID (+)	48	9481.2 (4738.4)	7750 (2600–20400)	0.153
Hb (g/dL)	COVID (-)	253	13.21 (2.21)	13.4 (3.30–17.80)	0.029
Hb (g/dL)	COVID (+)	48	12.48 (2.33)	12.6 (8.10–17.00)	0.029
Platelet (mm³)	COVID (-)	253	243.27 (89.72)	232 (29–688)	0.683
Platelet (mm³)	COVID (+)	48	254.7 (106.4)	232 (47–523)	0.683
CRP (mg/dL)	COVID (-)	253	4.51 (6.65)	1.30 (0.02–33.0)	0.281
CRP (mg/dL)	COVID (+)	48	6.37 (8.93)	1.55 (0.07–31.40)	0.281
RDW	COVID (-)	253	14.66 (2.10)	14.10 (12.10–24.90)	0.176
RDW	COVID (+)	48	15.3 (2.85)	14.35 (11.9–24.1)	0.176
LMR	COVID (-)	253	2.72 (2.03)	2.10 (0.10–13.90)	0.503
LMR	COVID (+)	48	2.32 (1.32)	1.90 (0.30–5.80)	0.503
NMR	COVID (-)	253	13.25 (17.55)	8.90 (0.90–190.20)	0.608
NMR	COVID (+)	48	11.6 (10.5)	8.95 (2.10–65.90)	0.608
MER	COVID (-)	253	17.77 (29.49)	7 (0.10–173.0)	0.008
MER	COVID (+)	48	24.57 (26.45)	13.0 (1.30–94.0)	0.008
Urea (mg/dL)	COVID (-)	253	38.84 (38.64)	29.50 (8.60–528.0)	0.136
Urea (mg/dL)	COVID (+)	48	48.56 (44.10)	34.40 (11.40–277.0)	0.136
Creatinine (mg/dL)	COVID (-)	253	1.04 (0.79)	0.88 (0.29–7.70)	0.815
Creatinine (mg/dL)	COVID (+)	48	1.14 (0.88)	0.86 (0.45–5.89)	0.815
Albumin (g/dL)	COVID (-)	253	4.07 (0.610)	4.23 (1.82–5.02)	0.194
Albumin (g/dL)	COVID (+)	48	3.88 (0.77)	4.18 (2.17–5.05)	0.194

Groups		Albumin		Total	χ²	SD	P^* P*: Chi-Square Test, Reference Group: COVID (+). SD: standard deviation; B:beta; SE:standard error; df:degree of freedom; Sig.:significant; Exp (B): expected beta.	Effect Size (ϕ)
Groups		Low	High	Total	χ²	SD		Effect Size (ϕ)
COVID (-)	f	42	211	253	4.207	1	0.040	0.118
	for COVID %	16.6%	83.4%	100.0%
	for albumin %	75.0%	86.1%	84.1%
COVID (+)	f	14	34	48
	for COVID %	29.2%	70.8%	100.0%
	for albumin %	25.0%	13.9%	15.9%
		B		S.E.	Wald	df	Sig.	Exp(B)
Serum albumin >2.5 g/dL		727		360	4.084	1	043	2.069
Invariant		-1.825		185	97.579	1	000	161

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[1] Corresponding author: drcananakman@gmail.com