Effects of Uric Acid on Disease Severity and Mortality in Hospitalized Covid-19 Patients

Abstract

Objective: High and low uric acid (UA) levels in the general population are associated with mortality. Information on the association of UA levels with clinical outcomes in COVID-19 patients is contradictory. We investigated the relationship between UA levels and clinical endpoints in COVID-19 patients.Methods: Laboratory and clinical parameters, including UA at the admission of hospitalized COVID-19 patients, were recorded retrospectively. Binary logistic regression analysis determined risk factors for mortality and the intensive care unit (ICU) needs. Results: This study included 708 patients (57.1% men), and the median age was 63 (18-98) years. Two hundred and three (28.7%) patients needed ICU, and 107 (15.7%) died. Uric acid levels were significantly higher in the deceased (6.5 vs. 4.9; p<0.001). Uric acid levels were similar in patients who needed ICU and those who did not (5 vs. 5.1; p=0.348). High UA (>median value 5.1 mg/dL) group have higher mortality rate (22.4% vs. 9.5%; p<0.001). In multivariate analyses, a high UA level was a risk factor for mortality [OR 1.93 (1.08 – 3.44); p=0.026]. In addition, age [OR 1.03 (1.01 – 1.05); p=0.004], albumin [OR 0.30 (0.17 - 0.52); P<0.001], neutrophil-to-lymphocyte ratio [OR 1.04 (1.01 – 1.06); p=0.003] and procalcitonin [OR 1.06 (1.0 – 1.11); p=0.048] was associated with mortality. A high UA level was not a risk factor for ICU need (p=0.780).Conclusion: High serum UA level affects mortality in COVID-19 patients. Risk assessment for the prognosis of patients can be made according to the UA levels at admission.