Urine biomarkers for the prediction of mortality in COVID-19 hospitalized patients

Risk factors associated with severity and mortality attributable to COVID-19 have been reported in different cohorts, highlighting the occurrence of acute kidney injury (AKI) in 25% of them. Among other, SARS-CoV-2 targets renal tubular cells and can cause acute renal damage. The aim of the present...

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Bibliographic Details
Authors: Morell Garcia, Daniel, Ramos-Chavarino, David, Bauça, Josep Miquel, Argente del Castillo, Paula, Ballesteros-Vizoso, Maria Antonieta, García de Guadiana-Romualdo, Luis, Gomez-Cobo, Cristina, Albert Pou, J, Amezaga-Menendez, Rocio, Alonso-Fernandez, Alberto, Llompart, Isabel, Garcia-Raja, Ana
Format: article
Publication Date:2021
Country:España
Institution:Instituto de Salud Carlos III (ISCIII)
Repository:Repisalud
Language:English
OAI Identifier:oai:repisalud.isciii.es:20.500.12105/23322
Online Access:https://hdl.handle.net/20.500.12105/23322
Access Level:Open access
Keyword:Modelos Logísticos
Lesión Renal Aguda
Biomarcadores
Orina
Femenino
Estudios Observacionales como Asunto
COVID-19
Hospitalización
Masculino
Factores de Riesgo
Humanos
Persona de Mediana Edad
Cuidados Críticos
Pronóstico
Anciano
Índice de Severidad de la Enfermedad
Estudios Retrospectivos
Adulto
Área Bajo la Curva
Curva ROC
Area Under Curve
Aged
Adult
Critical Care
Humans
Observational Studies as Topic
Middle Aged
Prognosis
Hospitalization
Male
Severity of Illness Index
Biomarkers
Acute Kidney Injury
Female
Risk Factors
ROC Curve
Urine
Logistic Models
Retrospective Studies
Description
Summary:Risk factors associated with severity and mortality attributable to COVID-19 have been reported in different cohorts, highlighting the occurrence of acute kidney injury (AKI) in 25% of them. Among other, SARS-CoV-2 targets renal tubular cells and can cause acute renal damage. The aim of the present study was to evaluate the usefulness of urinary parameters in predicting intensive care unit (ICU) admission, mortality and development of AKI in hospitalized patients with COVID-19. Retrospective observational study, in a tertiary care hospital, between March 1st and April 19th, 2020. We recruited adult patients admitted consecutively and positive for SARS-CoV-2. Urinary and serum biomarkers were correlated with clinical outcomes (AKI, ICU admission, hospital discharge and in-hospital mortality) and evaluated using a logistic regression model and ROC curves. A total of 199 COVID-19 hospitalized patients were included. In AKI, the logistic regression model with a highest area under the curve (AUC) was reached by the combination of urine blood and previous chronic kidney disease, with an AUC of 0.676 (95%CI 0.512-0.840; p=0.023); urine specific weight, sodium and albumin in serum, with an AUC of 0.837 (95% CI 0.766-0.909; p<0.001) for ICU admission; and age, urine blood and lactate dehydrogenase levels in serum, with an AUC of 0.923 (95%CI 0.866-0.979; p<0.001) for mortality prediction. For hospitalized patients with COVID-19, renal involvement and early alterations of urinary and serum parameters are useful as prognostic factors of AKI, the need for ICU admission and death.

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