Tags

Type your tag names separated by a space and hit enter

Diagnostic performance of initial blood urea nitrogen combined with D-dimer levels for predicting in-hospital mortality in COVID-19 patients.
Int J Antimicrob Agents. 2020 Sep; 56(3):106110.IJ

Abstract

The crude mortality rate in critical pneumonia cases with coronavirus disease 2019 (COVID-19) reaches 49%. This study aimed to test whether levels of blood urea nitrogen (BUN) in combination with D-dimer were predictors of in-hospital mortality in COVID-19 patients. The clinical characteristics of 305 COVID-19 patients were analysed and were compared between the survivor and non-survivor groups. Of the 305 patients, 85 (27.9%) died and 220 (72.1%) were discharged from hospital. Compared with discharged cases, non-survivor cases were older and their BUN and D-dimer levels were significantly higher (P < 0.0001). Least absolute shrinkage and selection operator (LASSO) and multivariable Cox regression analyses identified BUN and D-dimer levels as independent risk factors for poor prognosis. Kaplan-Meier analysis showed that elevated levels of BUN and D-dimer were associated with increased mortality (log-rank, P < 0.0001). The area under the curve for BUN combined with D-dimer was 0.94 (95% CI 0.90-0.97), with a sensitivity of 85% and specificity of 91%. Based on BUN and D-dimer levels on admission, a nomogram model was developed that showed good discrimination, with a concordance index of 0.94. Together, initial BUN and D-dimer levels were associated with mortality in COVID-19 patients. The combination of BUN ≥ 4.6 mmol/L and D-dimer ≥ 0.845 μg/mL appears to identify patients at high risk of in-hospital mortality, therefore it may prove to be a powerful risk assessment tool for severe COVID-19 patients.

Authors+Show Affiliations

Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Department of Health Management Centre, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Department of Anesthesiology, Hanyang Branch, Wuhan Hospital of Traditional Chinese Medicine, Wuhan, China.Department of Health Management Centre, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Department of Health Management Centre, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Department of Health Management Centre, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Department of Urology, Central Hospital of Shaoyang, University of South China, Hengyang, China.Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden.Cancer Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Center for Biomedical Research, NHC Key Laboratory of Respiratory Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Health Management Centre, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Electronic address: lvyongman@126.com.Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Electronic address: qqliutj@163.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32712332

Citation

Cheng, Anying, et al. "Diagnostic Performance of Initial Blood Urea Nitrogen Combined With D-dimer Levels for Predicting In-hospital Mortality in COVID-19 Patients." International Journal of Antimicrobial Agents, vol. 56, no. 3, 2020, p. 106110.
Cheng A, Hu L, Wang Y, et al. Diagnostic performance of initial blood urea nitrogen combined with D-dimer levels for predicting in-hospital mortality in COVID-19 patients. Int J Antimicrob Agents. 2020;56(3):106110.
Cheng, A., Hu, L., Wang, Y., Huang, L., Zhao, L., Zhang, C., Liu, X., Xu, R., Liu, F., Li, J., Ye, D., Wang, T., Lv, Y., & Liu, Q. (2020). Diagnostic performance of initial blood urea nitrogen combined with D-dimer levels for predicting in-hospital mortality in COVID-19 patients. International Journal of Antimicrobial Agents, 56(3), 106110. https://doi.org/10.1016/j.ijantimicag.2020.106110
Cheng A, et al. Diagnostic Performance of Initial Blood Urea Nitrogen Combined With D-dimer Levels for Predicting In-hospital Mortality in COVID-19 Patients. Int J Antimicrob Agents. 2020;56(3):106110. PubMed PMID: 32712332.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diagnostic performance of initial blood urea nitrogen combined with D-dimer levels for predicting in-hospital mortality in COVID-19 patients. AU - Cheng,Anying, AU - Hu,Liu, AU - Wang,Yiru, AU - Huang,Luyan, AU - Zhao,Lingxi, AU - Zhang,Congcong, AU - Liu,Xiyue, AU - Xu,Ranran, AU - Liu,Feng, AU - Li,Jinping, AU - Ye,Dawei, AU - Wang,Tao, AU - Lv,Yongman, AU - Liu,Qingquan, Y1 - 2020/07/23/ PY - 2020/04/08/received PY - 2020/07/15/revised PY - 2020/07/19/accepted PY - 2020/7/28/pubmed PY - 2020/9/12/medline PY - 2020/7/27/entrez KW - Blood urea nitrogen KW - COVID-19 KW - D-dimer KW - Viral pneumonia SP - 106110 EP - 106110 JF - International journal of antimicrobial agents JO - Int J Antimicrob Agents VL - 56 IS - 3 N2 - The crude mortality rate in critical pneumonia cases with coronavirus disease 2019 (COVID-19) reaches 49%. This study aimed to test whether levels of blood urea nitrogen (BUN) in combination with D-dimer were predictors of in-hospital mortality in COVID-19 patients. The clinical characteristics of 305 COVID-19 patients were analysed and were compared between the survivor and non-survivor groups. Of the 305 patients, 85 (27.9%) died and 220 (72.1%) were discharged from hospital. Compared with discharged cases, non-survivor cases were older and their BUN and D-dimer levels were significantly higher (P < 0.0001). Least absolute shrinkage and selection operator (LASSO) and multivariable Cox regression analyses identified BUN and D-dimer levels as independent risk factors for poor prognosis. Kaplan-Meier analysis showed that elevated levels of BUN and D-dimer were associated with increased mortality (log-rank, P < 0.0001). The area under the curve for BUN combined with D-dimer was 0.94 (95% CI 0.90-0.97), with a sensitivity of 85% and specificity of 91%. Based on BUN and D-dimer levels on admission, a nomogram model was developed that showed good discrimination, with a concordance index of 0.94. Together, initial BUN and D-dimer levels were associated with mortality in COVID-19 patients. The combination of BUN ≥ 4.6 mmol/L and D-dimer ≥ 0.845 μg/mL appears to identify patients at high risk of in-hospital mortality, therefore it may prove to be a powerful risk assessment tool for severe COVID-19 patients. SN - 1872-7913 UR - https://www.unboundmedicine.com/medline/citation/32712332/Diagnostic_performance_of_initial_blood_urea_nitrogen_combined_with_D_dimer_levels_for_predicting_in_hospital_mortality_in_COVID_19_patients_ DB - PRIME DP - Unbound Medicine ER -