The Prognostic Capabilities of C-Reactive Protein Versus Ferritin Levels in Stratifying Mechanically Ventilated Critically I'll Covid-19 Infected Patients Associated Complications And Mortality

BACKGROUND/AIM: Clinical features of patients with Covid-19 diseases have revealed several biochemical markers associated with in-hospital mortality. In particular, the blood levels of C-reactive protein and ferritin levels are the most correlated positive phase reactants that are commonly used in clinical practices for theirs diagnostic and prognostic values. For this reason, our main goal was to assess the complications and mortality prognostic value for the two tested prognosticators in mechanically ventilated critically ill COVID-19 infected patients. METHODS: A retrospective study was conducted in our Royal Medical Services institutions for all mechanically ventilated critically I'll COVID-19 infected patients. An Independent T, Mann Whitney-U, and Chi Square Tests were used to analyze the parametric and non-parametric outcomes’ data. A receiver operating characteristic was plotted to determine the area under the curve of each tested prognosticator and to identify the optimal cutoff point, sensitivity, specificity, Youden index, accuracy, and positive/negative predictive values. RESULTS: The mean age of the whole study cohort was 58.37±9.96 years, and the Survivors Cohort were insignificantly older than the Non-Survivors Cohort (58.55±9.95 years versus 58.09±10.05 years, respectively, p>0.05). Significantly, males were distributed in the study in approximately a 2: 1 ratio compared to females. Overall 28-day ICU mortality was detected in 94 (48.70%) during an average of 12.40±4.79 days of ICU length of stay. Biochemically, the c-reactive protein and ferritin were significantly higher in the Non-Survivors Cohort than in the Survivors Cohort [143.09±59.28 mg/dl and 891.51±377.82 ng/ml vs 88.38±34.38 mg/dl and 465.76±154.07 ng/ml, respectively, p<0.05]. CONCLUSION: The exaggerated elevation of serum levels of c-reactive protein and ferritin in COVID-19 infected patients, especially the mechanically ventilated critically ill cohort, can be potentially used for their reasonable performances and prediction utility in early identification and stratification of COVID-19 infected patients severities despite global ever-shrinking in medical teams and facilities, especially in critical care units to make sure optimum resource provision and implement swift management protocols.