Blood Urea Nitrogen/Albumin Ratio and Mortality Risk in Patients with COVID-19

Abstract

IntroductionWe researched blood urea nitrogen (BUN), albumin and their ratio (BAR), and compared them with C-reactive protein (CRP), D-dimer, and computed tomography severity scores (CT-SS), to predict in-hospital mortality.MethodsOne-hundred and thirty-one coronavirus disease-2019 (COVID-19) confirmed patients brought to the emergency department (ED) were dispensed to the survivor or non-survivor group, in light of in-hospital mortality. Information on age, gender, complaints, comorbidities, laboratory parameters, and outcome were gathered from the patient's record files.ResultsThe median BUN, mean total protein, mean albumin, median BAR, median creatinine, median CRP, and median D-dimer were recorded. CT-SS were utilized in categorizing the patient as mild, moderate, and severe. In-hospital mortality occurred in 42 (32.06%) patients (non-survivor group) and did not occur in 89 (67.94%) patients (survivor group). The median BUN (mg/dL) and BAR (mg/gm) values were significantly raised in the non-survivor group than in the survivor group [BUN: 23.48 (7.51–62.75) and 20.66 (4.07–74.67), respectively (p = 0.009); BAR: 8.33 mg/g (2.07–21.86) and 6.11 mg/g (1.26–23.33); (p = 0.0003)]. The mean albumin levels (gm/dL) in the non-survivor group were significantly lower than in the survivor group [2.96 ± 0.35 and 3.27 ± 0.35, respectively (p <0.0001)]. Albumin with an odd's ratio of 6.14 performed the best in predicting in-hospital mortality, followed by D-dimer (4.98). BAR and CRP had similar outcome of 3.75; BUN showed an OR of 3.13 at the selected cutoff value.ConclusionThe BUN, albumin, and BAR were found to be dependable predictors of in-hospital mortality in COVID-19 patients, with albumin (hypoalbuminemia) performing even better.How to cite this articleSingh S, Singh K. Blood Urea Nitrogen/Albumin Ratio and Mortality Risk in Patients with COVID-19. Indian J Crit Care Med 2022;26(5):626–631.