A novel combined index of D‑Dimer, Fibrinogen, Albumin, and Platelet (FDAPR) as mortality predictor of COVID‑19

Abstract

Background: In coronavirus disease 2019 (COVID‑19) caused by SARSCoV2 viruses, coagulation abnormalities are strongly correlated between disease severity and mortality risk. Aims: The aim was to search for new indices to determine mortality risk. Fibrinogen times D‑dimer to albumin times platelet ratio calculated with the formula (FDAPR index: ((Fibrinogen × D‑dimer)/(Albumin × Platelet)) investigated as a mortality marker in COVID‑19 patients. The hospitalization data of 1124 patients were analyzed from the electronic archive system. Hemogram, coagulation, and inflammatory markers were investigated in the study group. Materials and Methods: All statistical analyses like the student t‑test, Mann–Whitney U, Kaplan–Meier, and Cox hazard ratio, were performed with the SPSS 22.0 program. Results: Prothrombin time was prolonged significantly in patients (P < 0.05) compared to healthy subjects (n = 30). D‑dimer and fibrinogen were high, and albumin and platelet counts were low in COVID‑19 patients (all, P < 0.001). When the data of 224 non‑survivors and 900 survived patients were compared, D‑dimer and fibrinogen were higher, and albumin and platelet lower (all, P < 0.001) compared to mild and severe patients. At the cut‑off value of 0.49, the FDAPR index was performed with 89.1% sensitivity and 88.6% specificity. FDAPR index had the highest mortality predictive power (P < 0.01; HR = 5.366; 95% CI; 1.729–16.654). Conclusions: This study revealed that the FDAPR index could be used as a mortality marker of COVID‑19 disease.