Abstract:

Purpose: There are various diagnostic difficulties in identifying COVID-19 patients with a risk of poor prognosis at first reception to the intensive care unit. The concentration of acute phase proteins synthesized by the liver increases or decreases in the serum after inflammation and infection. This study aims to determine the predictive value of acute phase proteins in critical COVID-19 patients and evaluate the effectiveness of inflammatory indicators in predicing the risk of mortality in the intensive care unit. Tool and Method: This retrospective study was done in critical COVID-19 patients who were treated in the intensive care unit. The study included 123 patients with ARDS and/or multiple organ dysfunction in the first 24 hours of admission to the intensive care unit. At the end of the 28 days in the intensive care unit, surviving (n = 54) and dead (n = 69) patients groups or invasive mechanical ventilation (n = 83) and non-applicated (n = 40) patients groups were formed. The values of serum amyloid A, C-reactive protein, albumin and prealbumin, which are acute phase proteins, were compared within the first 24 hours of reception to the intensive maintenance unit. Results: The levels of album and prealbum have significantly decreased in patients who died (respectively p=0.011, p<0.001) and mechanical ventilation (respectively p=0.010, p=0.006). In patients with mechanical ventilation, serum amyloid A levels increased significantly (p=0.022). Result: Low levels of prealbumin and albumin and high levels of serum amyloid A during reception to the intensive care unit can be used as a prognostic indicator of disease severity and mortality.