Article Data

  • Views 1862
  • Dowloads 215

Original Research

Open Access

The utility of hemoglobin, albumin, lymphocyte and platelet (HALP) score in predicting mortality among COVID-19 patients: a preliminary study

  • Mazlum Kılıç1,*,
  • Rohat Ak2
  • Halil Alışkan3

1Department of Emergency Medicine, Fatih Sultan Mehmet Education and Research Hospital, 34752 Istanbul, Turkey

2Department of Emergency Medicine, Kartal Dr. Lütfi Kırdar City Hospital, 34865 Istanbul, Turkey

3Department of Emergency Medicine, Şişli Hamidiye Etfal Education and Research Hospital, 34371 Istanbul, Turkey

DOI: 10.22514/sv.2022.080 Vol.19,Issue 1,January 2023 pp.143-147

Submitted: 02 October 2022 Accepted: 28 October 2022

Published: 08 January 2023

*Corresponding Author(s): Mazlum Kılıç E-mail:


Several scoring systems are used to predict critical care requirements in coronavirus disease 2019 (COVID-19) patients. This study aims to determine the relationship between the hemoglobin, albumin, lymphocyte, and platelet (HALP) scores and in-hospital mortality for COVID-19 patients who visited the emergency department (ED). This retrospective study included patients over 18 years of age. Data were scanned into a digital information system of the hospital. The area under the receiver operating characteristic (ROC) curve and the area under the curve (AUC) were used to measure each discriminant cutoff value to predict mortality. A total of 458 patients were included in this study. The mean age of the patients was 72 years, and 216 (47.2%) patients were women. ROC analysis was performed to examine the predictive power of the HALP score in predicting mortality in COVID-19 patients, with an AUC of 0.720 (95%confidence interval: 0.676–0.761), a Youden index of 0.357, and a p value of 0.001. As a result of the statistical analysis, it was determined that the HALP score was statistically significant in the prediction of mortality in COVID-19 patients (p < 0.001). In this study, we found that the HALP score could be a good predictor of in-hospital mortality among COVID-19 patients.


COVID-19; HALP score; Mortality

Cite and Share

Mazlum Kılıç,Rohat Ak,Halil Alışkan. The utility of hemoglobin, albumin, lymphocyte and platelet (HALP) score in predicting mortality among COVID-19 patients: a preliminary study. Signa Vitae. 2023. 19(1);143-147.


[1] Ciotti M, Ciccozzi M, Terrinoni A, Jiang WC, Wang CB, Bernardini S. The COVID-19 pandemic. Critical Reviews in Clinical Laboratory Sciences. 2020; 57: 365–388.

[2] COVID‐19. Corona virus pandemic. Retrieved from 2022. Available at: (Accessed: 13 July 2022).

[3] El-Shabasy RM, Nayel MA, Taher MM, Abdelmonem R, Shoueir KR, Kenawy ER. Three waves changes, new variant strains, and vaccination effect against COVID-19 pandemic. International Journal of Biological Macromolecules. 2022; 204: 161–168.

[4] Sandhu P, Shah AB, Ahmad FB, Kerr J, Demeke HB, Graeden E, et al. Emergency department and intensive care unit overcrowding and ventilator shortages in us hospitals during the COVID-19 pandemic, 2020–2021. Public Health Reports. 2022; 137: 796–802.

[5] Ak R, Kurt E, Bahadirli S. Comparison of 2 risk prediction models specific for COVID-19: the Brescia-COVID respiratory severity scale versus the quick COVID-19 severity index. Disaster Medicine and Public Health Preparedness. 2021; 15: e46–e50.

[6] Champion HR. Trauma scoring. Scandinavian Journal of Surgery. 2002; 91: 12–22.

[7] Calder PC. Nutrition and immunity: lessons for COVID-19. Nutrition & Diabetes. 2021; 11: 19.

[8] Guijosa A, Calderillo-Ruiz G, Munoz Montano WR, Vazquez Renteria RS, Castillo Morales C, Herrera M, et al. HALP index prognostic significance for colon cancer patients in a Hispanic-based population. Journal of Clinical Oncology. 2022; 40: e15521.

[9] Peng D, Zhang C, Tang Q, Zhang L, Yang K, Yu X, et al. Prognostic significance of the combination of preoperative hemoglobin and albumin levels and lymphocyte and platelet counts (HALP) in patients with renal cell carcinoma after nephrectomy. BMC Urology. 2018; 18: 20.

[10] Feng JF, Wang L, Yang X. The preoperative hemoglobin, albumin, lymphocyte and platelet (HALP) score is a useful predictor in patients with resectable esophageal squamous cell carcinoma. Bosnian Journal of Basic Medical Sciences. 2021; 21: 773–781.

[11] Nakeshbandi M, Maini R, Daniel P, Rosengarten S, Parmar P, Wilson C, et al. The impact of obesity on COVID-19 complications: a retrospective cohort study. International Journal of Obesity. 2020; 44: 1832–1837.

[12] Liu X, Zhang R, He G. Hematological findings in coronavirus disease 2019: indications of progression of disease. Annals of Hematology. 2020; 99: 1421–1428.

[13] Oh SM, Skendelas JP, Macdonald E, Bergamini M, Goel S, Choi J, et al. On-admission anemia predicts mortality in COVID-19 patients: a single center, retrospective cohort study. The American Journal of Emergency Medicine. 2021; 48: 140–147.

[14] Bellmann-Weiler R, Lanser L, Barket R, Rangger L, Schapfl A, Schaber M, et al. Prevalence and predictive value of anemia and dysregulated iron homeostasis in patients with COVID-19 infection. Journal of Clinical Medicine. 2020; 9: 2429.

[15] Eckart A, Struja T, Kutz A, Baumgartner A, Baumgartner T, Zurfluh S, et al. Relationship of nutritional status, inflammation, and serum albumin levels during acute illness: a prospective study. The American Journal of Medicine. 2020; 133: 713–722.e7.

[16] Ak R, Doğanay F, Yilmaz E. Comparison of C-reactive protein and C-reactive protein-to-albumin ratio in predicting mortality among geriatric coronavirus disease 2019 patients. Journal of the Brazilian Medical Association. 2022; 68: 82–86.

[17] Violi F, Cangemi R, Romiti GF, Ceccarelli G, Oliva A, Alessandri F, et al. Is Albumin predictor of mortality in COVID-19? Antioxidants & Redox Signaling. 2021; 35: 139–142.

[18] Aziz M, Fatima R, Lee-Smith W, Assaly R. The association of low serum albumin level with severe COVID-19: a systematic review and meta-analysis. Critical Care. 2020; 24: 255.

[19] Ruan Q, Yang K, Wang W, Jiang L, Song J. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Medicine. 2020; 46: 846–848.

[20] Lin L, Lu L, Cao W, Li T. Hypothesis for potential pathogenesis of SARS-CoV-2 infection–a review of immune changes in patients with viral pneumonia. Emerging Microbes & Infections. 2020; 9: 727–732.

[21] Huang I, Pranata R. Lymphopenia in severe coronavirus disease-2019 (COVID-19): systematic review and meta-analysis. Journal of Intensive Care. 2020; 8: 36.

[22] Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The Lancet. 2020; 395: 507–513.

[23] Guan W, Ni Z, Hu Y, Liang W, Ou C, He J, et al. Clinical characteristics of coronavirus disease 2019 in China. The New England Journal of Medicine. 2020; 382: 1708–1720.

[24] Yang X, Yang Q, Wang Y, Wu Y, Xu J, Yu Y, et al. Thrombocytopenia and its association with mortality in patients with COVID-19. Journal of Thrombosis and Haemostasis. 2020; 18: 1469–1472.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.

Index Copernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.

Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.

Scopus: CiteScore 1.0 (2022) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.

Submission Turnaround Time