Abnormal Indexes of Liver and Kidney Injury Markers Predict Severity in COVID-19 Patients

Abstract

Background SARS-CoV-2 can damage not only the lungs but also the liver and kidney. Most critically ill patients with coronavirus disease 2019 (COVID-19) have liver and kidney dysfunction. We aim to investigate the levels of liver and kidney function indexes in mild and severe COVID-19 patients and their capability to predict the severity of the disease. Methods The characteristics and laboratory indexes were compared between patients with different conditions. We applied binary logistic regression to find the independent risk factors of severe patients. Receiver operating characteristic (ROC) analysis was used to predict the severity of COVID-19 using the liver and kidney function indexes. Results This study enrolled 266 COVID-19 patients, including 235 mild patients and 31 severe patients. Compared with mild patients, severe patients had lower albumin (ALB) and higher alanine aminotransferase (ALT), aspartate aminotransferase (AST), and urea nitrogen (BUN) (all p<0.001). Binary logistic regression analysis also identified ALB [OR=0.273 (0.079–0.947), p=0.041] and ALT [OR=2.680 (1.036–6.934), p=0.042] as independent factors of severe COVID-19 patients. Combining ALB, ALT, BUN, and LDH exhibited the area under ROC at 0.914, with a sensitivity of 86.7% and specificity of 83.0%. Conclusion COVID-19 patients, especially severe patients, have damage to liver and kidney function. ALT, AST, LDH, and BUN could be independent factors for predicting the severity of COVID-19. Combining the ALB, ALT, BUN, and LDH could predict the transition from mild to severe in COVID-19 patients.

Paraoxonase Activity an Independent Contributor in SARS-CoV-2 Infection

“…These findings are in agreement with previous studies stating that liver injury occurs during highly pathogenic human coronavirus infections, moreover abnormalities in laboratory indexes of blood biochemical parameters, may be associated with the severity of multiple organ dysfunction. 14,[27][28][29] Out of 73 patients 13 patients died from SARS-CoV-2 infection having decreased PON1 activity (1.19±0.46 kU/L) as compared to survivors (1.31±0.56 kU/L) (p>0.05, data not shown). Among all variables examined, PON1 and urea were found to be associated with SARS-CoV-2 infection.…”

Feasibility analysis and mechanism exploration of Rhei Radix et Rhizome−Schisandrae Sphenantherae Fructus (RS) against COVID-19

“…SARS-CoV-2 can cause inflammatory injury of liver, and ALB is an important indicator reflecting the severity of liver inflammatory injury in clinic. More and more studies have found that ALB is closely related to the severity of COVID-19 patients [51], which can reflect the prognosis of patients [52]. In addition, ALB is an important index for judging nucleic acid negative within 14 days [53].…”

A Review of Routine Laboratory Biomarkers for the Detection of Severe COVID-19 Disease

“…Moreover, as observed in a multicenter retrospective cohort study of 12,413 confirmed COVID-19 patients, a significant association between increased baseline BUN levels and increased risk of all-cause mortality was VEGF would be useful in the approach to the regeneration of lung tissue and treatment of lung fibrosis [2,107,112] reported [121]. A recent study of 266 COVID-19 patients reported that compared with mild cases, severe patients had higher levels of BUN, proposing that BUN could be an independent element for predicting COVID-19 severity [122]. ese studies showed that higher BUN concentrations in COVID-19 cases were associated with higher disease severity and mortality rate.…”

“…Moreover, as observed in a multicenter retrospective cohort study of 12,413 confirmed COVID-19 patients, a significant association between increased baseline BUN levels and increased risk of all-cause mortality was reported [ 121 ]. A recent study of 266 COVID-19 patients reported that compared with mild cases, severe patients had higher levels of BUN, proposing that BUN could be an independent element for predicting COVID-19 severity [ 122 ].…”