Transactions of the Royal Society of Tropical Medicine and Hygiene · 2022
Elevated admission C-reactive protein to albumin ratios are associated with disease severity and respiratory complications in adults with imported falciparum malaria.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Hoffmeister Bodo, Aguilar Valdez Abner D
Аннотация
BACKGROUND: In imported falciparum malaria, systemic inflammation with increased capillary permeability can cause life-threatening complications, such as acute pulmonary edema (APO) or adult respiratory distress syndrome (ARDS). This observational study assessed the association of the admission serum albumin level (ALB) and C-reactive protein to albumin ratio (CRP/ALB) with disease severity and these respiratory complications.
METHODS: All adult cases hospitalized during 2001-2015 in the Charité University Hospital, Berlin, with ALB and CRP values measured upon admission, were retrospectively analysed.
RESULTS: Seventy-six patients were enrolled (26 female, median age: 37 y), 60 with uncomplicated malaria and 16 with severe malaria (SM). SM was associated with lower ALB (p<0.0001) and higher CRP/ALB (p<0.0001) values; the areas under the receiver operator curves (AUROCs) were 0.85 (95% CI 0.74 to 0.96) for ALB and 0.88 (95% CI 0.80 to 0.97) for CRP/ALB. Radiologic changes consistent with APO/ARDS were detectable in 5 of 45 admission chest X-rays performed (11.1%); the AUROCs were 0.86 (95% CI 0.74 to 0.99) for ALB and 0.91 (95% CI 0.82 to 0.99) for CRP/ALB.
CONCLUSIONS: Diminished admission ALB levels and elevated CRP/ALB ratios are associated with disease severity and respiratory complications in imported falciparum malaria. These readily and ubiquitously available markers may facilitate early identification of at-risk patients.
METHODS: All adult cases hospitalized during 2001-2015 in the Charité University Hospital, Berlin, with ALB and CRP values measured upon admission, were retrospectively analysed.
RESULTS: Seventy-six patients were enrolled (26 female, median age: 37 y), 60 with uncomplicated malaria and 16 with severe malaria (SM). SM was associated with lower ALB (p<0.0001) and higher CRP/ALB (p<0.0001) values; the areas under the receiver operator curves (AUROCs) were 0.85 (95% CI 0.74 to 0.96) for ALB and 0.88 (95% CI 0.80 to 0.97) for CRP/ALB. Radiologic changes consistent with APO/ARDS were detectable in 5 of 45 admission chest X-rays performed (11.1%); the AUROCs were 0.86 (95% CI 0.74 to 0.99) for ALB and 0.91 (95% CI 0.82 to 0.99) for CRP/ALB.
CONCLUSIONS: Diminished admission ALB levels and elevated CRP/ALB ratios are associated with disease severity and respiratory complications in imported falciparum malaria. These readily and ubiquitously available markers may facilitate early identification of at-risk patients.