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Research paper

Could De Ritis score be a useful predictor of mortality in COVID-19 patients who require intensive care?

By
Ibrahim Karagoz ,
Ibrahim Karagoz
Ital Ilker ,
Ital Ilker
Bahri Ozer ,
Bahri Ozer
Gulali Aktas
Gulali Aktas

Abstract

Inflammatory markers are being investigated as possible predictors of mortality in intensive care population. COVID-19 infection causes significant amount of inflammatory burden. De Ritis score has been suggested as a novel disease marker in conditions characterized with inflammation. In the present work, we aimed to compare De Ritis scores of deceased and survived COVID-19 patients in an institutional intensive care unit. Patients treated in intensive care unit with a diagnosis of COVID-19 infection were enrolled in the study. De Ritis scores of the deceased and survived subjects were compared. The De Ritis score among survivors and non-survivors was 1.12 (range: 0.3-6.9)% and 1.43 (range: 0.2-16)%, respectively, with a statistically significant difference (p = 0.03). Additionally, the De Ritis score exhibited significant positive correlations with lactate dehydrogenase (LDH) (r = 0.37, p < 0.001), D-dimer (r = 0.38, p < 0.001), and C-reactive protein (CRP) (r = 0.19, p = 0.01) levels. When the De Ritis score exceeded the 1.32% threshold, its sensitivity and specificity in predicting mortality were 60% and 61%, respectively, with an area under the curve (AUC) of 0.61 (p = 0.03, 95% confidence interval: 0.52-0.7). Furthermore, each unit increase in the De Ritis score was associated with a 96% increase in the odds of mortality among COVID-19 patients treated in the intensive care unit (p = 0.03, OR: 0.96, 95% confidence interval: 0.86-0.98). De Ritis score can be a useful marker of poor prognosis in COVID-19 patients in intensive care units.

References

1.
Lee H, Lee SE, Byun S, Kim HH, Kwak C, Hong SK. De Ritis ratio (aspartate transaminase/alanine transaminase ratio) as a significant prognostic factor after surgical treatment in patients with clear‐cell localized renal cell carcinoma: a propensity score‐matched study. BJU International. 2017;119(2):261–7.

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