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Aim: Coronavirus disease 2019 (COVID-19) is an epidemic disease with variable symptoms and high mortality rates. Therefore, patient follow-up is very significant. We aimed to investigate whether blood urea nitrogen (BUN), D-dimer and lactate parameters, which are laboratory tests used in follow-up, predict mortality. Material(s) and Method(s): The study included 173 COVID-19 patients hospitalized in the pandemic intensive care unit from March 2020 to June 2020. We retrospectively recorded patient age, gender, comorbidity, radiological involvement, oxygen demand, APACHE scores, in-hospital mortality status, BUN, lactate, and D-dimer levels, BUN/D-dimer ratio (BDR), BUN/lactate ratio (BLR). Then we made the statistical comparison between the groups by grouping the patients as discharged and deceased. Result(s): Among the patients included in the study, 107 (61.8%) were male and 66 (38.2%) were female. The mean ages between those discharged and those who died in the hospital were 73 and 67.5 years, respectively, and there was a statistically significant difference. The median BUN, d-dimer, lactate and BDR, BLR values of the patients in the non-survivor group were significantly higher than those in the survivor group. BLR had the highest diagnostic ratio (25.03) for estimating in-hospital COVID-19 mortality. Discussion(s): We found that BUN, BDR, and BLR levels were reliable predictors of in-hospital mortality in COVID-19 patients. However, BLR was a potent risk assessment tool, especially in defining the risk of in-hospital death.Copyright © 2022, Derman Medical Publishing. All rights reserved.
RESUMEN
BACKGROUND AND AIM: The 2019 coronavirus disease (COVID-19) is an epidemic disease with variable symptoms and high mortality rates. Therefore, patient follow-up is very significant. We also investigated whether blood urea nitrogen (BUN), D-dimer and lactate parameters, which laboratory tests used in follow-up, predict mortality. METHODS: 173 COVID-19 patients hospitalized in the pandemic intensive care unit within the period from March to June 2020 were included in the study. Retrospectively, we recorded the patient's age, gender, comorbidity, radiological involvement, oxygen demand, APACHE scores, in-hospital mortality status, BUN, lactate, and D-dimer levels, BUN/D-dimer ratio (BDR), BUN/lactate ratio (BLR). Then we made the statistical comparison between the groups by grouping the patients as discharged and deceased. RESULTS: of the patients included in the study, 107 (61.8%) were male and 66 (38.2%) were female. The mean ages between those discharged and those who died in the hospital are 73 and 67.5 years, respectively, and there is a statistically significant difference. The median BUN, d-dimer, lactate and BDR, BLR values of the patients in the survivor group were significantly higher than those in the survivor group. BUN: 38 [25-60] and 23 [14-34] [p < 0.001], respectively;Lactate: 1.81[1.3-2.7] and 1.56 [1.2-1.9] [p < 0.05], respectively;D-dimer: 2430 [1401-4300] and 1710 [965-4204] [p < 0.05], respectively;BDR: 0.016 [0.009- 0.029] and 0.011 [0.007-0.026] [p < 0.05]);. BLR: 19.24 [10.38-30.99] and 14.15 [8.79-22.92] [p < 0.05], respectively). In estimating in-hospital COVID-19 mortality, the area under the curve (AUC) for BUN was the highest (0.74), and the diagnostic odds ratio was the highest for BLR (25.03) CONCLUSIONS: We found that BUN, BDR, and BLR levels were reliable predictors of in-hospital mortality in COVID-19 patients. However, BLR was a potent risk assessment tool, especially in defining the risk of in-hospital death.
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BACKGROUND AND STUDY AIMS: To investigate the clinical and laboratory characteristics of the cases with high lipase levels in the course of COVID-19. PATIENTS AND METHODS: Hospital records of all cases, where lipase levels were measured, and the reverse transcriptase-polymerase chain reaction test due to SARS-CoV-2 was found positive, were retrospectively investigated. Of 127 COVID-19 patients tested for lipase, 20 (15.7%) had serum lipase levels above the upper laboratory limit. The patient group with the "high lipase level" was created from these subjects, and the rest constituted the "control" group. RESULTS: While body mass index (BMI) levels were higher in the high lipase group, (p=0.014), the number of those with pre-existing diabetes mellitus (DM) was also found higher in the high lipase group than the controls (p=0.002). The history of DM was detected to increase the risk of developing high lipase level 4.63 times higher. Only two patients were diagnosed with acute pancreatitis (AP). While oxygen saturations on admission (p=0.019) and discharge (p=0.011) were lower in the high lipase group than the controls, amylase (p<0.001), C-reactive protein (CRP) (p=0.002) and D-dimer (p=0.004) levels were found higher. In addition, more patients required the treatment in intensive care unit in the high lipase group, compared to the controls (p=0.027). Accordingly, time of hospital stay became also prolonged (p=0.003). CONCLUSIONS: Pancreatic injuries or even AP may develop during SARS-CoV-2 infection, especially in those with pre-existing DM. Monitoring of pancreatic enzymes is important in COVID-19 patients, especially with pre-existing DM.