Could the Lactate-Albumin Ratio be Successful in Predicting Mortality due to COVID-19 Infection?

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BACKGROUND/AIMS: High death rates are associated with coronavirus disease-2019 (COVID-19), particularly in severely ill hospitalized patients.Early detection of particularly severe cases will be beneficial for treatment decisions and clinical courses.Therefore, we aimed to discern the capacity of the lactate-albumin ratio (LAR) parameter in predicting the outcomes of patients admitted to the intensive care unit (ICU) to COVID-19 infection. MATERIALS AND METHODS:The study comprised 535 COVID-19-diagnosed patients who were admitted to the ICU.The data of the patients were obtained by retrospectively scanning the patient files. RESULTS:The study population consisted of 535 patients, 270 patients in the non-survival group and 265 patients in the survival group.In the non-survival group, the plasma lactate level was 2.3±1.4 mmol/L, whereas in the survival group, it was 1.74±0.8mmol/L, and this difference was statistically significantly higher in the non-survival group (p<0.001).The plasma albumin level in the non-survival group was also 2.87±0.47g/dL, whereas in the survival group, it was 3.36±0.55g/dL.It was determined that this difference was statistically significant (p<0.001).The cut-off value of lactate in determining mortality in critically progressing COVID-19 patients was 1.725 [area under the curve (AUC): 0.637, %95 confidence interval (CI): 0.590-0.685]with 63% sensitivity and 60% specificity; albumin 3.03 (AUC: 0.763, 95% CI: 0.723-0.803)with 70% sensitivity and 66% specificity; and LAR 0.57 (AUC: 0.719, 95% CI: 0.676-0.763)with 68% sensitivity and 68% specificity. CONCLUSION:LAR can be safely used as a sepsis-related mortality marker in the ICU.However, although LAR is a successful indicator in patients hospitalized in the ICU because of COVID-19, it has yet to be as successful as it was in patients with sepsis.Its routine use may facilitate more information about LAR and patient decision-making.