Serum Cystatin C Levels as a Predictor of Severity and Mortality Among Patients With COVID-19 Infection

Abstract

Introduction: The pandemic caused by SARS Corona Virus-2 (COVID-19) has caused widespread mortality globally. The hallmark of the disease is the "cytokine storm," which is caused due to dysregulated immune system activation. Numerous inflammatory markers are used to predict the severity and mortality of the infection. Serum Cystatin C levels are associated with immune responses to exogenous and endogenous antigens. Our study was done to assess serum cystatin C as a marker of severity and mortality among patients admitted with COVID-19 infection. Methodology: This cross-sectional study was conducted in a tertiary care center in South India. Sixty-nine patients with mild and severe COVID-19 infection admitted to the hospital were included in the study. Serum Cystatin C levels were estimated at admission. The levels were correlated with disease severity and mortality. Receiver operating characteristic curves (ROCs) was constructed for Cystatin C to predict severity and mortality. The computation of sensitivity, specificity, and positive and negative predictive values was done using optimal cut-off points. SPSS 18 was used for the statistical analysis. Version 18.0 of PASW Statistics for Windows. SPSS Inc., Chicago. Results: Out of 69 patients, 28 (40.5%) had a mild illness, and 41 patients (59.4%) had severe COVID-19 illness. Mean serum Cystatin C levels measured at the time of admission among patients with mild illness was 1.83 (SD-1.53), and among patients with severe illness was 3.84 (SD- 2.59) (p<0.001). The area under receiver operating characteristic curves (ROC) for serum cystatin C for predicting COVID-19 severity and mortality was 0.904 and 0.768, respectively (p<0.001). Conclusion: Patients with severe COVID-19 disease had considerably higher serum levels of Cystatin C than those with mild COVID-19 illness. Cystatin C levels can be useful for predicting mortality and severity among patients admitted with COVID-19 infection.

New Predictive Biomarkers for Screening Covid-19 Patients With Rhabdomyolysis in Combination With Cystatin C

“…By employing different grouping models, our study demonstrated that CysC was a significant evaluation indicator associated with the prognosis of COVID-19 patients, which was consistent with previous research findings (20,21,25,33,34). We further confirmed that CysC was directly connected to the occurrence of RM and SKM injury in COVID-19 patients and had a good predictive value for these patients.…”

“…It has been shown that CysC is closely associated with the prognosis of a variety of diseases, including coronary heart disease, vascular disease, and stroke (17–19). Meanwhile, studies have shown that in hospitalized COVID-19 patients, higher serum concentrations of CysC, which may indicate one or more processes such as worsening renal function, excessive inflammation, anti-viral activity, and cytokine storm, are associated with severe illness and higher mortality (20,21). When compared with raised serum creatinine (Cr), high CysC has a better predictive value for disease severity in COVID-19 patients and can be used to identify renal function issues early (22,23).…”