Abstract
BackgroundCoronavirus disease causes a proximal tubule dysfunction of kidneys, inducing uric acid loss [1]. It has been established that several changes in laboratory markers (C-reactive protein (CRP), ferritin, interleukin-6 (IL-6)) can predict the severity of Covid-19 [2]. The purpose of this retrospective study was to analyze whether uric acid could act as another predictor of severe Covid-19.ObjectivesTo evaluate the relationship between the severity of Covid-19 and uric acid levels on admission to the hospital.MethodsThis retrospective study included 150 hospitalized patients with confirmed Covid-19 (mean age 60.3±14.6 years; 52% were men), the severity of which was determined by the presence and type of oxygen support: (1) without O2, (2) O2 by mask or nasal cannula, (3) continuous positive airway pressure, (4) positive bi-pressure in the airways or high-flow oxygen, (5) invasive ventilation. Among them, 90 subjects required oxygen support, and 60 people didn’t. The mortality rate in our study was 9.3%. The average uric acid level was compared with patients without Covid-19 (40 subjects). The study included patients who didn’t receive urate-lowering therapy. Levels of CRP, ferritin, IL-6, D-dimer were also determined on admission. The Spearman’s rank coefficient was used for measuring correlation.ResultsThe mean uric acid level in patients with coronavirus disease was 251.5±104.1 µmol/L; without Covid-19 it was significantly higher — 328.6±96.9 µmol/L (p<0.001). Approximately one in four (24.6%) Covid-19 patients had uric acid levels below the lower limit of normal (208 µmol/L for men, 155 µmol/L for women). A decrease in serum uric acid levels was also observed in patients suffering from asymptomatic hyperuricemia or gout. However, there was no correlation between uric acid levels and disease severity (r=0.01, p=0.88). Also, uric acid levels did not correlate with other laboratory markers of severe Covid-19 (CRP: r=0.07, p=0.73; ferritin: r=0.15, p=0,07; IL-6: r=0.11, p=0,22; D-dimer: r=0.02, p=0,79).ConclusionLow uric acid levels are common in patients with Covid-19, but are not predictive of a more severe course of this disease. A correlation between uric acid and the level of other laboratory markers of severe Covid-19 was not found.
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