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INFLAMMATORY RATIO BIOMARKERS FOR PROGNOSTIC AND THERAPEUTIC GUIDANCE IN CRITICAL COVID-19 CARE

DEJANA D. BAJIĆ ¹*, NEMANJA B. TODOROVIĆ ², MLADENA N. LALIĆ POPOVIĆ ² , LJILJANA N. ANDRIJEVIĆ 1

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This study examines the prognostic value of the neutrophil-to-lymphocyte ratio (NLR), fibrinogen-to-albumin ratio (FAR), and C-reactive protein-to-albumin ratio (CAR) as accessible indicators of inflammation and metabolic imbalance in critically ill patients with COVID-19-related sepsis. A total of 133 patients admitted to the intensive care unit were retrospectively analysed. Biomarker values obtained within the first 24 hours of admission were evaluated for their ability to predict 28-day mortality using receiver operating characteristic (ROC) curves and logistic regression analysis. Among the tested ratios, CAR (cut-off 5.5; AUC = 0.665) and NLR (cut-off 25; AUC = 0.663) showed the strongest predictive accuracy for early mortality, whereas FAR demonstrated a weaker association. Elevated CAR and NLR levels were closely linked to poor outcomes, and CAR was identified as the most reliable independent predictor (p = 0.015). These findings suggest that inflammation-based ratios, particularly NLR and CAR, provide simple, cost-effective tools for early risk assessment and can complement personalized therapeutic strategies in critical care.