A linear relationship between De Ritis ratio and mortality in hospitalized patients with COVID-19:A secondary analysis based on a large retrospective cohort study

Background and aims:Although some studies have identified a possible link between the De Ritis ratio and the mortality of patients with COVID-19),the predictive value and the optimal cut-value remain unclear.This study aimed to explore the correlation between the De Ritis ratio and mortality in hospitalized COVID-19.Methods:The data for this cohort study came from a retrospective cohort study that was carried out in a medical system in New York City.The primary outcome was the in-hospital mortality of included patients.The researchers ran multivariate Cox regression analyses,curve fitting,and subgroup analysis to support our findings.Overall survival in different De Ritis ratio groups was plotted as Kaplan-Meier survival curves.Results:The study enrolled 4371 participants with COVID-19 from March 1,2020 to April 16,2020.The overall mortality was 24.8%(1082/4371).The curve fitting analyses indicated that the De Ritis ratio has a positive linear connection with mortality in patients with COVID-19.After adjusting for all covariates,participants with a De Ritis ratio≥2 exhibited 1.29 times the risk of in-hospital mortality compared with those with a De Ritis ratio<1(hazard ratio 1.29,95%confidence interval 1.02-1.62,p=0.031).The p for trend was<0.05 for all models.Patients in the group with a De Ritis ratio≥2 experienced the shortest survival time in the Kaplan-Meier survival analysis.Conclusions:A higher baseline De Ritis ratio is correlated with a corresponding higher mortality among hospitalized people with COVID-19.