Cystatin C is a marker for acute kidney injury, but not for mortality among COVID-19 patients in Mexico

Ramos-Santos, Karime; Cortés-Télles, Arturo; Uc-Miam, María Elena; Ávila-Nava, Azalia; Lugo, Roberto; Aké, Rodolfo Chim; Gutiérrez-Solís, Ana Ligia

doi:10.1016/j.bjid.2022.102365

Cited by 3 publications

(8 citation statements)

References 23 publications

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“…Two hundred ninety-three duplicates were removed, and the remaining 131 articles were screened by title and abstract, which resulted in the exclusion of 92 irrelevant articles. Full-text screening was performed on 39 studies, and data for 25 studies were extracted for this meta-analysis [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 ]. Figure 1 depicts the various exclusions and selection procedures.…”

Section: Resultsmentioning

confidence: 99%

“…The systematic review included articles published between 2020 and 2022, comprising a total of 3916 COVID-19 participants ( Table 1 ). The final set considered of 25 eligible studies [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 ], including 18 articles conducted in China [ 21 , 22 , 23 , 25 , 26 , 27 , 28 , 31 , 33 , 34 , 36 , 37 , 38 , 39 , 41 , 42 , 43 , 44 ], two articles in Turkey [ 32 , 40 ], and one article each from the following countries: Iraq [ 20 ], India [ 24 ], Mexico [ 29 ], USA [ 30 ] and Egy...…”

Section: Resultsmentioning

confidence: 99%

“…The results of our meta-analysis show the potential clinical role of Cystatin C in predicting severe COVID-19 in patients. Serum Cystatin C concentrations in particular were linked to COVID-19 mortality [ 21 , 24 , 26 , 27 , 28 , 29 , 35 , 36 , 39 , 42 ], severity [ 20 , 22 , 23 , 24 , 27 , 28 , 31 , 32 , 33 , 34 , 36 , 37 , 38 , 39 , 41 , 42 , 43 , 44 ], and the onset of acute kidney injury [ 29 , 30 , 35 , 40 ].…”

Section: Discussionmentioning

confidence: 99%

“…The diamonds represent pooled results. Legend: CI: confidence interval; SD: standard deviation [ 21 , 24 , 25 , 26 , 28 , 29 , 35 , 36 , 39 , 42 ].…”

Section: Figurementioning

confidence: 99%

“…The diamonds represent pooled results. Legend: AKI: acute kidney injury; CI: confidence interval; SD: standard deviation [ 29 , 30 , 35 , 40 ].…”

Section: Figurementioning

confidence: 99%

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Prognostic Performance of Cystatin C in COVID-19: A Systematic Review and Meta-Analysis

Matuszewski

Reznikov

Pruc³

et al. 2022

IJERPH

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Cystatin C is a specific biomarker of kidney function. We perform this meta-analysis to determine the association of Cystatin C with the COVID-19 severity. In this systematic review and meta-analysis, we searched PubMed, EMBASE, Cochrane library, and Web of Science for studies published until 2nd September 2022 that reported associations between Cystatin C levels and COVID-19 severity. The analysis was performed using a random-effects model to calculate pooled standard mean difference (SMD). Twenty-five studies were included in the meta-analysis. Pooled analysis showed statistically significant differences of Cystatin C levels among survive vs. decreased patients (0.998 ± 0.225 vs. 1.328 ± 0.475 mg/dL, respectively; SMD = −2.14; 95%CI: −3.28 to −1.01; p < 0.001). Cystatin C levels in COVID-19 severe vs. non-severe groups varied and amounted to 1.485 ± 1.191 vs. 1.014 ± 0.601 mg/dL, respectively (SMD = 1.81; 95%CI: 1.29 to 2.32; p < 0.001). Additionally, pooled analysis showed that Cystatin C levels in patients with acute kidney injury (AKI) was 1.562 ± 0.885 mg/dL, compared to 0.811 ± 0.108 mg/dL for patients without AKI (SMD = 4.56; 95%CI: 0.27 to 8.85; p = 0.04). Summing up, Cystatin C is a potentially very good marker to be used in the context of COVID-19 disease due to the prognosis of patients’ serious condition, risk of AKI and mortality. In addition, Cystatin C could be used as a marker of renal complications in COVID-19 other than AKI due to the need to monitor patients even longer after leaving the hospital.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…The diamonds represent pooled results. Legend: CI: confidence interval; SD: standard deviation [ 21 , 24 , 25 , 26 , 28 , 29 , 35 , 36 , 39 , 42 ].…”

Section: Figurementioning

confidence: 99%

“…The diamonds represent pooled results. Legend: AKI: acute kidney injury; CI: confidence interval; SD: standard deviation [ 29 , 30 , 35 , 40 ].…”

Section: Figurementioning

confidence: 99%

See 3 more Smart Citations

Prognostic Performance of Cystatin C in COVID-19: A Systematic Review and Meta-Analysis

Matuszewski

Reznikov

Pruc³

et al. 2022

IJERPH

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The Predictive Value of Cystatin C for AKI in Patients with COVID-19

Magomedaliev¹,

Korabelnikov²,

Khoroshilov

2023

Obŝaâ reanimatologiâ

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Objective. To evaluate a potential of cystatin C blood concentration to predict acute kidney injury (AKI) in patients with severe and extremely severe pneumonia associated with a COVID-19.Materials and methods. An observational prospective study of 117 patients with severe and extremely severe pneumonia associated with a COVID-19 in an ICU setting was conducted in 2020-2022 (site: multi-functional Medical Center, 1586 Military Clinical Hospital of the Ministry of Defense of Russia, Moscow Region, Russia). Routine laboratory tests and instrumental examinations were performed according to generally accepted protocols. Cystatin C concentrations in blood (s-CysC) and urine (u-CysC) were measured by immunoturbidimetric method.Results. AKI was diagnosed in 21 (17.9%) patients, kidney dysfunction without AKI was found in 22 (18.8%) patients with severe and extremely severe pneumonia associated with COVID-19. s-CysC and u-CysC levels in the group of patients with AKI were statistically significantly higher compared to the levels in the group of patients without AKI. The levels of s-CysC obtained within Day 1 — T (-1), and Day 2 — T (-2) prior to AKI onset turned out to be the independent factors for AKI development in patients with severe and extremely severe pneumonia associated with COVID-19: OR 5.37, Wald chisquare 5.534 (CI: 1.324; 21.788); P=0.019 and OR 3.225, Wald chi-square 4.121 (CI: 1.041; 9.989); P=0.042, respectively. s-CysC T (-2) value is informative, and s- CysC T (-1) is a highly informative predictor of AKI development in severe and extremely severe pneumonia associated with COVID-19: ROC AUC 0.853 (95% CI, 0.74-0.966), P<0.001) with 90% sensitivity and 73% specificity at a cut-off of 1.67 mg/L, and ROC AUC 0.905 (95% CI, 0.837-0.973), P<0.001) with 90% sensitivity and 73% specificity at a cut-off of 1.69 mg/l, respectively. Serum CysC levels started increasing 3 days prior to AKI onset, outpacing the increase of SCr levels. The u-CysC levels were not predictive of AKI development. Impaired renal function probability was increasing with patients' age (P<0.0001).Conclusions. Serum CysC seems to be a statistically significant predictor of AKI. s-CysC levels started increasing 3 days prior to AKI onset, surpassing the increase of SCr levels in patients with severe and extremely severe pneumonia associated with COVID-19. Urine CysC did not achieve statistical significance as a predictor for AKI, although u-CysC concentrations were significantly higher on days 3, 2, 1 prior to AKI onset and on the day of AKI onset in the group of patients with AKI.

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Diagnostic Significance of Serum Cystatin C as A Predictor of Severity in COVID-19 Infected Egyptian Patients

Ashry,

Elzefzafy,

Abouzahab

et al. 2023

International Journal of Medical Arts

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Article informationBackground: may produce a systemic inflammatory state and multiorgan dysfunction, including renal damage. Biochemical and radiological tests are important in assessing disease severity and selecting therapeutic options. Serum cystatin C [sCys C] is involved in immunomodulatory responses in inflammatory conditions and infections, and it reflects changes in borderline renal function. The Aim of the work: Measurement of serum cystatin C levels in COVID-19 infected Egyptian participants as a predictor of the disease`s severity. Patients and Methods: This was an observational case-control study carried out on 80 participants, including 60 Egyptian COVID-19 patients and 20 healthy individuals as controls. All participants were investigated for laboratory, medical, and radiological features of COVID-19 as well as serum cystatin C. Patients were distributed into three categories according to illness severity; each group involved 20 patients: mild cases [group I], moderate cases [group II], and severe cases [group III].Results: Serum cystatin C levels were found to be higher in group III patients, with a highly statistically significant difference between groups. Group III patients had higher levels of CRP, D-dimer, serum urea, and creatinine, with a highly statistically significant difference between groups. With a cutoff of >9.6, there was a significant link between serum systatin C and the severity of COVID-19 disease, with 96.8% sensitivity and 100% specificity. Conclusion:The present study indicates that serum systatin C may serve as a tool for diagnosing potentially severe cases of COVID-19 infected Egyptian patients.

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Cystatin C is a marker for acute kidney injury, but not for mortality among COVID-19 patients in Mexico

Cited by 3 publications

References 23 publications

Prognostic Performance of Cystatin C in COVID-19: A Systematic Review and Meta-Analysis

Prognostic Performance of Cystatin C in COVID-19: A Systematic Review and Meta-Analysis

The Predictive Value of Cystatin C for AKI in Patients with COVID-19

Diagnostic Significance of Serum Cystatin C as A Predictor of Severity in COVID-19 Infected Egyptian Patients

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