Predictive values of blood urea nitrogen/creatinine ratio and other routine blood parameters on disease severity and survival of COVID‐19 patients

Abstract

We aimed to examine independent predictive factors for the severity and survival of COVID‐19 disease, from routine blood parameters, especially the blood urea nitrogen (BUN)/creatinine (Cr) ratio. A total of 139 patients with COVID‐19 were investigated at Siirt State Hospital. According to the disease severity, the patients were categorized as three groups (moderate: 85, severe: 54, and critical: 20). Then, patients were divided into two groups: nonsevere (moderate) and severe (severe and critical). Demographic, clinical data, and routine blood parameters were analyzed. In multivariate model adjusted for potential confounders BUN/Cr ratio (odds ratio [OR] = 1.70; 95% confidence interval [CI]: 1.20‐2.40; P = .002) and neutrophil to lymphocyte ratio (NLR) (OR = 2.21; 95% CI: 1.20‐4.30; P < .001) were independent predictive factors for disease severity. In multivariate Cox proportional hazard model BUN/Cr ratio (hazard ratio [HR] = 1.02; 95% CI: 1.01‐1.05; P = .030), and NLR (HR = 1.17; 95% CI: 1.06‐1.30; P = .020) were independent predictors for survival of COVID‐19 disease. The optimal thresholds of the BUN/Cr ratio at 33.5 and 51.7 had the superior possibility for severe disease and mortality, area under the curve (AUC) were 0.98 and 0.95, respectively. The optimal thresholds of NLR at 3.27 and 5.72 had a superior possibility for severe disease and mortality, AUC were 0.87 and 0.85, respectively. BUN/Cr and NLR are independent predictors for COVID‐19 patient severity and survival. Routine evaluation of BUN/Cr and NLR can help identify high‐risk cases with COVID‐19.

Platelet-to-lymphocyte ratio, a novel biomarker to predict the severity of COVID-19 patients: A systematic review and meta-analysis

“…Overall, six studies were done in China 10 , 11 , 14 – 17 and only one was done outside of China, in Turkey. 18 All studies compared the on-admission PLR values between severe and non-severe COVID-19 patients, except for one that compared the PLR values between severe and moderate COVID-19 patients (Table 1). 17 Unfortunately, no study explored the prognostic value of PLR on admission to predict mortality.…”

“…The possible reasons for the high heterogeneity could be due to the distinct interstudy baseline characteristics of the subjects, different number, and proportion of patients with comorbidities as well as the proportion of severe and non-severe cases. Fesih, Qu, and Sun excluded patients with other comorbidities, such as chronic lung diseases, hematological diseases, and liver diseases 10 , 16 , 18 while Gong did not provide any data on the comorbidities of the patients. 14 Another reason could be due to the small number of included studies in this meta-analysis, which could reduce the accuracy of the heterogeneity analysis.…”

Predictive values of neutrophil-to-lymphocyte ratio on disease severity and mortality in COVID-19 patients: a systematic review and meta-analysis

“…The remaining 42 studies were further scrutinized by reading the full text. Finally, only 19 studies were included in this metaanalysis, of which 9 reported the predictive value on disease severity [26][27][28][29][30][31][32][33][34], 6 reported the predictive value on mortality [35][36][37][38][39][40], and 4 reported the predictive value on both disease severity and mortality [41][42][43][44].…”

Predictive values of neutrophil-to-lymphocyte ratio on disease severity and mortality in COVID-19 patients: a systematic review and meta-analysis

“…The remaining 42 studies were further scrutinized by reading the full text. Finally, only 19 studies were included in this meta-analysis, of which 9 reported the predictive value on disease severity [26][27][28][29][30][31][32][33][34], 6 reported the predictive value on mortality [35][36][37][38][39][40], and 4 reported the predictive value on both disease severity and mortality [41][42][43][44].…”