The lethal dance of Covid-19 with sepsis: predicting mortality using C-reactive protein, red cell distribution width, albumin and their ratios

Le résumé fourni par la source

Aims: This study aimed to assess the impact of sepsis or secondary infection on mortality among COVID-19 patients admitted to the intensive care unit (ICU), and to evaluate the prognostic utility of C-reactive protein (CRP), red cell distribution width(RDW), albumin levels, and their derived ratios—CRP/Albumin (CAR), RDW/Albumin (RAR), and CRP×RDW/Albumin (CRAR). Methods: A retrospective cohort of 471 patients aged 18–75 years, treated between January and May 2021 at XXX XXX City Hospital, was analyzed. Patients were classified into three groups: isolated COVID-19, COVID-19 with sepsis, and COVID-19 with secondary non-sepsis infection. Demographic and clinical characteristics, as well as ICU mortality rates, were compared between survivors and non-survivors. The predictive value of CAR, RAR, and CRAR ratios was statistically evaluated. Results: Sepsis was associated with significantly higher mortality, age, APACHE II scores, lactate, and procalcitonin levels. Deceased patients had lower albumin levels and higher RDW and RAR values. ROC analysis revealed that RDW and RAR were significant predictors of mortality in the isolated COVID-19 group, while albumin and RAR were significant in the secondary infection group. Although univariate analysis highlighted associations between RAR and CRAR with mortality, multivariate analysis identified age, lactate, and sepsis status as independent predictors; notably, sepsis increased mortality by approximately 2.8-fold. Conclusion: Sepsis dramatically increases mortality risk in COVID-19 ICU patients. RDW, albumin, and their corresponding ratios offer practical value for risk stratification, but must be interpreted within the context of established risk factors such as age and lactate. These biomarkers can aid prognostication, yet should be validated across larger and multicentric cohorts for wider clinical application.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.