The Value of C-Reactive Protein-to-Lymphocyte Ratio in Predicting the Severity of SARS-CoV-2 Pneumonia

Abstract

Background: We aim to describe biological features and outcomes of 240 patients admitted for SARS-CoV-2 pneumonia, as well as identify predictors of intensive care unit (ICU) admission, need for invasive mechanical ventilation and in-hospital mortality.

Materials and methods: Retrospective, observational study, all consecutive patients with laboratory-confirmed SARS-CoV-2 infection and pneumonia admitted to the Hospital Clinic of Barcelona between February 28th and April 21st, 2020. Patients were divided into two groups: non-ICU and ICU-admitted.

Results: Among the 800 patients admitted for SARS-CoV-2, we analyzed data of 240 patients with COVID-19 pneumonia (115 non-ICU and 125 ICU-admitted). The mean age 57.7 (SD: 17.8) years, 67% were male. The median duration of onset of symptoms to hospital admission was 7 (4; 8) days. Patients with higher BMI and elevated levels of C-reactive protein-to-lymphocyte ratio and ferritin upon admission presented with an increased risk of ICU admission. Ferritin levels and the C-reactive protein-to-lymphocyte ratio upon admission were independently associated with the need for IMV. Platelet levels were an additional variable associated with ICU admission in both patients who went directly to the ICU and those who transferred to the ICU within 96h of admission to the emergency department.

Conclusion: Early recognition of markers such as serum ferritin, D-dimer, platelet count and the C-reactive protein-to-lymphocyte ratio could help identify and prioritize patients with a higher probability for ICU admission and need of IMV during the course of hospitalization.