Analyses of Kidney Biomarkers in Patients With SARS-CoV-2 (COVID-19)
-
Mohammad Bakhshivand
,
Farid Ghorbaninezhad
,
Tohid Kazemi
,
Parisa Lotfinejad
,
Vahid Khaze
,
Jalil Masoudfar
,
Somayye Mirzaei
,
Zahra Asadzadeh
,
Khalil Hajiasgharzadeh
,
Afshin Derakhshani
,
Nazila Alizadeh
,
Behzad Baradaran
Abstract
The new coronavirus was first reported in China and caused a widespread global outbreak of pneumonia that spread rapidly across this country and many other countries. Acute kidney injury is one of the important complications of COVID-19, which has been shown in some cases. Exploring the diagnostic features of biomarkers of kidney function in COVID-19 patients may lead to better patient management. We collected laboratory data from 206 people with confirmed COVID-19 disease and evaluated their renal biomarkers, Blood Urea Nitrogen (BUN), and creatinine. The age range of the patients was almost 62 years old. The mean age in the dead patients and recovered patients was 71 and 54 years old, respectively. The average LDH value was 755 U/L, and creatine phosphokinase (CPK) was 267 U/L in the patients. The average BUN was 59.1 U/L, and creatinine was 1.5 U/L in COVID-2019 patients. Among all 193 patients, laboratory results revealed that 163 (85.4 %) patients had an elevated BUN level. Based on creatinine levels for total patients, laboratory results revealed that 49 (25.4 %) patients had an elevated value. The average BUN value in dead patients was 85 mg/dL, while in recovered patients was 40.5 mg/dL (P<0.0001). Also, the average creatinine level in dead patients was 1.86 mg/dL, while in recovered patients was 1.24 mg/dL (P=0.0004). Inflammation following COVID-19 disease causes kidney damage and elevated urea and creatinine levels, which may increase the risk of death in these patients.
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24. Li Z, Wu M, Guo J, Yao J, Liao X, Song S, et al. Caution on kidney dysfunctions of 2019-nCoV patients. MedRxiv. 2020;
25. Vanmassenhove J, Kielstein J, Jörres A, Biesen W Van. Management of patients at risk of acute kidney injury. Lancet. 2017 May;389(10084):2139–51.
26. Ge S, Nie S, Liu Z, Chen C, Zha Y, Qian J, et al. Epidemiology and outcomes of acute kidney injury in elderly chinese patients: a subgroup analysis from the EACH study. BMC Nephrol. 2016 Dec 29;17(1):136.
27. Peiris J, Chu C, Cheng V, Chan K, Hung I, Poon L, et al. Clinical progression and viral load in a community outbreak of coronavirus-associated SARS pneumonia: a prospective study. Lancet. 2003 May;361(9371):1767–72.
28. Chu KH, Tsang WK, Tang CS, Lam MF, Lai FM, To KF, et al. Acute renal impairment in coronavirus-associated severe acute respiratory syndrome. Kidney Int. 2005 Feb;67(2):698–705.
29. Cheng Y, Luo R, Wang K, Zhang M, Wang Z, Dong L, et al. Kidney impairment is associated with in-hospital death of COVID-19 patients. MedRxiv. 2020;
30. Zheng Y-Y, Ma Y-T, Zhang J-Y, Xie X. COVID-19 and the cardiovascular system. Nat Rev Cardiol. 2020 May 5;17(5):259–60.
2. Pormohammad A, Ghorbani S, Khatami A, Farzi R, Baradaran B, Turner DL, et al. Comparison of confirmed COVID-19 with SARS and MERS cases - Clinical characteristics, laboratory findings, radiographic signs and outcomes: A systematic review and meta-analysis. Rev Med Virol [Internet]. 2020 Jun 5;30(4):e2112. Available from: http://www.ncbi.nlm.nih.gov/pubmed/32502331
3. Zhou P, Yang X-L, Wang X-G, Hu B, Zhang L, Zhang W, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020 Mar 3;579(7798):270–3.
4. Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, et al. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia. N Engl J Med. 2020 Mar 26;382(13):1199–207.
5. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020 Feb;395(10223):507–13.
6. Wang C, Horby PW, Hayden FG, Gao GF. A novel coronavirus outbreak of global health concern. Lancet. 2020 Feb;395(10223):470–3.
7. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China. JAMA. 2020 Mar 17;323(11):1061.
8. Brunetti O, Derakhshani A, Baradaran B, Galvano A, Russo A, Silvestris N. COVID-19 Infection in Cancer Patients: How Can Oncologists Deal With These Patients? Front Oncol. 2020 Apr 23;10.
9. Guan W, Ni Z, Hu YY, Liang W, Ou C, He J, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020 Apr 30;382(18):1708–20.
10. Paraskevis D, Kostaki EG, Magiorkinis G, Panayiotakopoulos G, Sourvinos G, Tsiodras S. Full-genome evolutionary analysis of the novel corona virus (2019-nCoV) rejects the hypothesis of emergence as a result of a recent recombination event. Infect Genet Evol. 2020 Apr;79:104212.
11. Lai C-C, Shih T-P, Ko W-C, Tang H-J, Hsueh P-R. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int J Antimicrob Agents. 2020 Mar;55(3):105924.
12. Liu Y, Du X, Chen J, Jin Y, Peng L, Wang HHX, et al. Neutrophil-to-lymphocyte ratio as an independent risk factor for mortality in hospitalized patients with COVID-19. J Infect. 2020 Jul;81(1):e6–12.
13. Zhang F, Liang Y. Potential risk of the kidney vulnerable to novel coronavirus 2019 infection. Am J Physiol Physiol. 2020 May 1;318(5):F1136–7.
14. Naicker S, Yang C-W, Hwang S-J, Liu B-C, Chen J-H, Jha V. The Novel Coronavirus 2019 epidemic and kidneys. Kidney Int. 2020 May;97(5):824–8.
15. Deng Y-Y, Zheng Y, Cai G-Y, Chen X-M, Hong Q. Single-cell RNA sequencing data suggest a role for angiotensin-converting enzyme 2 in kidney impairment in patients infected with 2019-novel coronavirus. Chin Med J (Engl). 2020 May;133(9):1129–31.
16. Khwaja A. KDIGO Clinical Practice Guidelines for Acute Kidney Injury. Nephron. 2012 Aug 7;120(4):c179–84.
17. Ronco C, Navalesi P, Vincent JL. Coronavirus epidemic: preparing for extracorporeal organ support in intensive care. Lancet Respir Med. 2020 Mar;8(3):240–1.
18. Kellum JA, Prowle JR. Paradigms of acute kidney injury in the intensive care setting. Nat Rev Nephrol. 2018 Apr 22;14(4):217–30.
19. Mandell LA, Wunderink RG, Anzueto A, Bartlett JG, Campbell GD, Dean NC, et al. Infectious Diseases Society of America/American Thoracic Society Consensus Guidelines on the Management of Community-Acquired Pneumonia in Adults. Clin Infect Dis. 2007 Mar 1;44(Supplement_2):S27–72.
20. Hu B, Zeng L-P, Yang X-L, Ge X-Y, Zhang W, Li B, et al. Discovery of a rich gene pool of bat SARS-related coronaviruses provides new insights into the origin of SARS coronavirus. Drosten C, editor. PLOS Pathog. 2017 Nov 30;13(11):e1006698.
21. Azhar EI, El-Kafrawy SA, Farraj SA, Hassan AM, Al-Saeed MS, Hashem AM, et al. Evidence for Camel-to-Human Transmission of MERS Coronavirus. N Engl J Med. 2014 Jun 26;370(26):2499–505.
22. Wang XF, Shi GC, Wan HY, Hang SG, Chen H, Chen W, et al. Clinical features of three avian influenza H7N9 virus-infected patients in Shanghai. Clin Respir J. 2014 Oct;8(4):410–6.
23. Hemmat N, Derakhshani A, Bannazadeh Baghi H, Silvestris N, Baradaran B, De Summa S. Neutrophils, Crucial, or Harmful Immune Cells Involved in Coronavirus Infection: A Bioinformatics Study. Front Genet. 2020 Jun 9;11.
24. Li Z, Wu M, Guo J, Yao J, Liao X, Song S, et al. Caution on kidney dysfunctions of 2019-nCoV patients. MedRxiv. 2020;
25. Vanmassenhove J, Kielstein J, Jörres A, Biesen W Van. Management of patients at risk of acute kidney injury. Lancet. 2017 May;389(10084):2139–51.
26. Ge S, Nie S, Liu Z, Chen C, Zha Y, Qian J, et al. Epidemiology and outcomes of acute kidney injury in elderly chinese patients: a subgroup analysis from the EACH study. BMC Nephrol. 2016 Dec 29;17(1):136.
27. Peiris J, Chu C, Cheng V, Chan K, Hung I, Poon L, et al. Clinical progression and viral load in a community outbreak of coronavirus-associated SARS pneumonia: a prospective study. Lancet. 2003 May;361(9371):1767–72.
28. Chu KH, Tsang WK, Tang CS, Lam MF, Lai FM, To KF, et al. Acute renal impairment in coronavirus-associated severe acute respiratory syndrome. Kidney Int. 2005 Feb;67(2):698–705.
29. Cheng Y, Luo R, Wang K, Zhang M, Wang Z, Dong L, et al. Kidney impairment is associated with in-hospital death of COVID-19 patients. MedRxiv. 2020;
30. Zheng Y-Y, Ma Y-T, Zhang J-Y, Xie X. COVID-19 and the cardiovascular system. Nat Rev Cardiol. 2020 May 5;17(5):259–60.
| Files | ||
| Issue | Vol 61 No 3 (2023) | |
| Section | Articles | |
| DOI | https://doi.org/10.18502/acta.v61i3.12739 | |
| Keywords | ||
| : Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Coronavirus disease 2019 (COVID-19) Kidney injury Renal biomarkers Blood urea nitrogen Creatinine | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Bakhshivand M, Ghorbaninezhad F, Kazemi T, Lotfinejad P, Khaze V, Masoudfar J, Mirzaei S, Asadzadeh Z, Hajiasgharzadeh K, Derakhshani A, Alizadeh N, Baradaran B. Analyses of Kidney Biomarkers in Patients With SARS-CoV-2 (COVID-19). Acta Med Iran. 2023;61(3):168-174.
