Ferritin, blood urea nitrogen, and high chest CT score determines ICU admission in COVID-19 positive UAE patients: A single center retrospective study

Abstract

Coronavirus Disease (COVID-19) was declared a pandemic by WHO in March 2020. Since then, additional novel coronavirus variants have emerged challenging the current healthcare system worldwide. There is an increased need for hospital care, especially intensive care unit (ICU), for the patients severely affected by the disease. Most of the studies analyzed COVID-19 infected patients in the hospitals and established the positive correlation between clinical parameters such as high levels of D-dimer, C-reactive protein, and ferritin to the severity of infection. However, little is known about the course of the ICU admission. The retrospective study carried out at University Hospital Sharjah, UAE presented here reports an integrated analysis of the biochemical and radiological factors among the newly admitted COVID-19 patients to decide on their ICU admission. The descriptive statistical analysis revealed that patients with clinical presentations such as acute respiratory distress syndrome (ARDS) (p<0.0001) at the time of admission needed intensive care. The ROC plot indicated that radiological factors including high chest CT scores (>CO-RADS 4) in combination with biochemical parameters such as higher levels of blood urea nitrogen (>6.7 mg/dL;66% sensitivity and 75.8% specificity) and ferritin (>290 μg/mL, 71.4% sensitivity and 77.8% specificity) may predict ICU admission with 94.2% accuracy among COVID-19 patients. Collectively, these findings would benefit the hospitals to predict the ICU admission amongst COVID-19 infected patients.

Blood Urea Nitrogen to Serum Albumin Ratio as A New Prognostic Indicator in Critically Ill Patients with Diabetic Ketoacidosis: A Retrospective Cohort Study

“…Previous studies have also revealed that high BUN levels are correlated with poor prognosis in ICU patients 24 25 . As high BUN was also found to be related to the poor prognosis of patients with acute heart failure, acute respiratory disease syndrome, and hepatic decompensation 26 27 28 , BUN might reflect the degree of injury of multiple important organs, which were also an important risk factor of critically ill patients.…”

“…Although many patients with DKA are complicated with acute renal failure, dehydration is the most common state among patients with DKA due to hypovolemia and hypotension Accepted Manuscript also revealed that high BUN levels are correlated with poor prognosis in ICU patients [24,25]. As high BUN was also found to be related to the poor prognosis of patients with acute heart failure, acute respiratory disease syndrome, and hepatic decompensation [26][27][28], BUN might reflect the degree of injury of multiple important organs, which were also found to be an important risk factor of critically ill patients.…”

Blood urea nitrogen and clinical prognosis in patients with COVID-19: A retrospective study

“…[25–28] In hospitalized ICU patients, elevated BUN levels indicate impaired renal function and are associated with poor prognosis. [29]…”

“…[25][26][27][28] In hospitalized ICU patients, elevated BUN levels indicate impaired renal function and are associated with poor prognosis. [29] For COVID-19, major risk factors reported previously include age, masculinity, obesity, smoking, and chronic comorbidities such as hypertension and diabetes. [30,31] In our study, we found that dead patients had a higher proportion of diabetes, lower hematocrit and calcium ion levels compared with survived patients.…”

“…We also identified BUN as the risk factor for 28-day mortality, consistent with previous reports. [ 19 , 29 ] Moreover, BUN could predict 28-day mortality of COVID-19 patients. In previous study BUN to albumin ratio could predict the mortality of COVID-19 patients.…”