Severe Coronavirus disease 2019 pneumonia patients showed signs of aggravated renal impairment

J Clin Lab Anal. 2020 Oct;34(10):e23535. doi: 10.1002/jcla.23535. Epub 2020 Aug 25.

Abstract

Background: This objective of this study was to identify a sensitive indicator of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.

Methods: Samples were collected from 136 patients with Coronavirus disease 2019 (COVID-19) pneumonia admitted to the Shanghai public health clinical center (116 mild, 20 severe). The concentrations of serum urea, Uric Acid (UA), Creatinine (CREA), Erythrocyte sedimentation rate (ESR), high-sensitivity C-reactive protein (hs-CRP), procalcitonin (PCT), and urine protein (Pro) have been tested in this study.

Results: Higher levels of urea (female 7.00 ± 3.31, male 8.87 ± 5.18) Pro (female7/7, male 12/13), hs-CRP (female 2/7, male 5/13) ESR (female 94.43 ± 33.26, male 67.85 ± 22.77) were found in severe patients compared with the mild (urea: female 3.71 ± 1.00, male 4.42 ± 1.14; Pro: female 3/46, male 12/70; hs-CRP: female 1/46, male 3/70; ESR: female 43.32 ± 33.24, male 21.64 ± 21.82). UA is lower in the severe group (female 146.90 ± 54.01, male 139.34 ± 66.95) than in mild group (female 251.99 ± 64.35, male 339.81 ± 71.32). CREA and PCT did not show a significant difference between mild and severe patients, but the difference among the five biological markers (urea, Pro, hs-CRP, ESR, and UA) between mild and severe patients we tested was small (P < .05).

Conclusion: Severe COVID-19 patients had higher levels of urea and Pro, while their UA levels were lower, reflecting poor kidney function in severe patients. However, higher levels of hs-CRP, ESR indicated that inflammatory responses were more active in severe patients.

Keywords: COVID-19; ESR; UA; creatinine; hs-CRP; procalcitonin; urea; urine protein.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Betacoronavirus*
  • Blood Sedimentation
  • C-Reactive Protein / analysis
  • COVID-19
  • Coronavirus Infections* / complications
  • Coronavirus Infections* / epidemiology
  • Creatinine / blood
  • Critical Illness
  • Female
  • Humans
  • Inflammation
  • Male
  • Middle Aged
  • Pandemics*
  • Pneumonia, Viral* / complications
  • Pneumonia, Viral* / epidemiology
  • Renal Insufficiency* / epidemiology
  • Renal Insufficiency* / virology
  • SARS-CoV-2
  • Young Adult

Substances

  • C-Reactive Protein
  • Creatinine