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Tytuł:
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Diagnostic performance of initial blood urea nitrogen combined with D-dimer levels for predicting in-hospital mortality in COVID-19 patients.
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Autorzy:
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Cheng A; Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Hu L; Department of Health Management Centre, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Wang Y; Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Huang L; Department of Anesthesiology, Hanyang Branch, Wuhan Hospital of Traditional Chinese Medicine, Wuhan, China.
Zhao L; Department of Health Management Centre, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Zhang C; Department of Health Management Centre, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Liu X; Department of Health Management Centre, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Xu R; Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Liu F; Department of Urology, Central Hospital of Shaoyang, University of South China, Hengyang, China.
Li J; Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden.
Ye D; Cancer Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Wang T; Center for Biomedical Research, NHC Key Laboratory of Respiratory Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Lv Y; Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Health Management Centre, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Electronic address: .
Liu Q; Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Electronic address: .
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Źródło:
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International journal of antimicrobial agents [Int J Antimicrob Agents] 2020 Sep; Vol. 56 (3), pp. 106110. Date of Electronic Publication: 2020 Jul 23.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Original Publication: Amsterdam : Elsevier Science Publishers, c1991-
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MeSH Terms:
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Blood Urea Nitrogen*
Betacoronavirus/*pathogenicity
Coronavirus Infections/*diagnosis
Coronavirus Infections/*mortality
Fibrin Fibrinogen Degradation Products/*metabolism
Pneumonia, Viral/*diagnosis
Pneumonia, Viral/*mortality
Aged ; Area Under Curve ; Biomarkers/blood ; COVID-19 ; Coronavirus Infections/blood ; Coronavirus Infections/virology ; Female ; Hospital Mortality ; Humans ; Male ; Middle Aged ; Pandemics ; Pneumonia, Viral/blood ; Pneumonia, Viral/virology ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Risk ; SARS-CoV-2
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References:
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Contributed Indexing:
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Keywords: Blood urea nitrogen; COVID-19; D-dimer; Viral pneumonia
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Substance Nomenclature:
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0 (Biomarkers)
0 (Fibrin Fibrinogen Degradation Products)
0 (fibrin fragment D)
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Entry Date(s):
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Date Created: 20200727 Date Completed: 20200910 Latest Revision: 20240329
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Update Code:
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20240329
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PubMed Central ID:
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PMC7377803
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DOI:
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10.1016/j.ijantimicag.2020.106110
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PMID:
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32712332
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The crude mortality rate in critical pneumonia cases with coronavirus disease 2019 (COVID-19) reaches 49%. This study aimed to test whether levels of blood urea nitrogen (BUN) in combination with D-dimer were predictors of in-hospital mortality in COVID-19 patients. The clinical characteristics of 305 COVID-19 patients were analysed and were compared between the survivor and non-survivor groups. Of the 305 patients, 85 (27.9%) died and 220 (72.1%) were discharged from hospital. Compared with discharged cases, non-survivor cases were older and their BUN and D-dimer levels were significantly higher (P < 0.0001). Least absolute shrinkage and selection operator (LASSO) and multivariable Cox regression analyses identified BUN and D-dimer levels as independent risk factors for poor prognosis. Kaplan-Meier analysis showed that elevated levels of BUN and D-dimer were associated with increased mortality (log-rank, P < 0.0001). The area under the curve for BUN combined with D-dimer was 0.94 (95% CI 0.90-0.97), with a sensitivity of 85% and specificity of 91%. Based on BUN and D-dimer levels on admission, a nomogram model was developed that showed good discrimination, with a concordance index of 0.94. Together, initial BUN and D-dimer levels were associated with mortality in COVID-19 patients. The combination of BUN ≥ 4.6 mmol/L and D-dimer ≥ 0.845 μg/mL appears to identify patients at high risk of in-hospital mortality, therefore it may prove to be a powerful risk assessment tool for severe COVID-19 patients.
(Copyright © 2020 Elsevier Ltd. All rights reserved.)
