Could De Ritis Score Be a Useful Predictor of Mortality in COVID-19 Patients Who Require Intensive Care?

Ibrahim Karagoz¹, Kasim Ilker Ital¹, Bahri Ozer², Gulali Aktas³

 

¹Abant Izzet Baysal University Hospital, Department of Anesthesiology, Bolu, Turkey
²Abant Izzet Baysal University Hospital, Department of General Surgery, Bolu, Turkey
³Abant Izzet Baysal University Hospital, Department of Internal Medicine, Bolu, Turkey

 

 SUMMARY

 

Introduction/Aim. 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.
Methods. 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.
Results. 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).
Conclusion. De Ritis score can be a useful marker of poor prognosis in COVID-19 patients in intensive care units.

Keywords: De Ritis score, inflammation, COVID-19, intensive care

 

Corresponding author:

Ibrahim Karagoz

e-mail:dr.ikar@hotmail.com