Fibrinogen and albumin are routinely used parameters in COVID-19. High fibrinogen levels and low albumin levels are associated with the severity of COVID-19 disease. Moreover, the fibrinogen to albumin ratio (FAR) level is known to be a better marker in cases of coagulopathy. A retrospective study was conducted to analyse the clinical benefits of FAR in COVID-19. 590 COVID-19 patients were evaluated and divided into two groups: survivors and non-survivors. The mean age of patients was 65.63±14.9 and 60% of patients were male.
The CRP, fibrinogen, albumin, and FAR levels were analyzed to identify the disease severity and mortality. The results found that the advanced age and male gender had a higher risk of mortality in COVID-19 patients. Also, it was observed that more than half of the patients had hypertension and approximately one-third of them had diabetes among the non-survivor group. Moreover, 97% and 70% of patients died during intensive care follow-up and treatment period, respectively. CRP, ferritin, LDH, and procalcitonin were significantly higher in deceased patients compared to recovered groups. The mean fibrinogen level, the albumin levels and mean FAR were 4.45±1.57 mg/dl, 28.6±4.6 g/L and 0.24±0.3 respectively in the non-survivor group. Whereas, the mean fibrinogen level, the albumin levels and mean FAR were 3.95±1.1 mg/dl, 33.5±5.6 g/L and 0.11±0.6 respectively in the survivor group.
The cut-off value of FAR for mortality was 0.13. Thus, increased FAR were found to be important markers in determining the mortality levels in Covid-19 patients. In conclusion, FAR, fibrinogen, CRP and its combination can be used to assess the severity of COVID-19. But FAR alone is a better parameter in determining the severity of COVID-19 disease. Thus, assessment of FAR ratio can help clinicians to accurately assess the disease at an early stage, identify severe patients, and take active treatment measures as soon as possible, so as to reduce the fatality rate.
Ref Link: Clinical Practice Wiley
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