The role of the lactate/albumin ratio in predicting mortality in COVID-19 patients in the emergency department

ABSTRACT

Objectives: The high mortality rate of coronavirus disease 2019 (COVID-19) and insufficient bed capacity create significant challenges in emergency department management. Therefore, this study investigated whether the lactate/albumin ratio (LAR) predicts mortality in COVID-19 patients in the emergency department.

Methods: The study included 504 COVID-19 patients who were brought to the emergency department from March to August 2020. Their lactate and albumin levels, LAR, age, gender, and in-hospital mortality status were recorded. The patients were grouped by in-hospital mortality, and a statistical comparison was conducted between the groups.

Results: Of the included patients, 252(50%) were male, and the median age was 61.5(47–72.75) years. There was in-hospital mortality in 79(15.7%) patients. The median lactate and LAR values of the patients in the non-survivor group were significantly higher than those in the survivor group (lactate: 2.05 [1.5– 3.4] and 1.6 [1.2–2], respectively [p<0.001]; LAR: 0.584 [0.406–0.956] and 0.38 [0.29–0.489], respectively [p<0.001]). The mean albumin value in the non-survivor group was significantly lower than that in the survivor group (3.68±0.58 and 4.19±0.48, respectively; p<0.001). The LAR area-under-the-curve (AUC) values obtained to predict in-hospital COVID-19 mortality were higher than those for lactate (AUC of LAR and lactate: 0.730 and 0.669, respectively). The AUC value of LAR was significantly higher than the AUC value of lactate (p<0.001).

Conclusion: LAR is a moderately accurate predictor of in-hospital mortality in COVID-19 patients, and LAR was found to be a more reliable predictor than lactate levels.

Key words: COVID-19, lactate, serum albumin, in-hospital mortality