Urea/albumin ratio associated with mortality in hospitalized COVID-19 patients: a cohort study

ABSTRACT

Introduction: higher value of urea/albumin (U/A) ratio is associated with higher risk of death in patients with pneumonia. It is known that infections by COVID-19 can lead to ICU admission and death, and, in this scenario, the evaluation of this marker can be useful to improve the management of these patients. Objective(s) to evaluate the U/A ratio as a predictor of mortality in patients hospitalized for COVID-19. Method(s) 252 unvacinated patients with COVID-19 hospitalized between April 2020 and February 2021 were included in this cohort and were assessed by complete blood count and laboratory analysis on the first and third day of hospitalization. Result(s) Of the total number of patients, 153 were hospitalized in a ward and, of these, 28 died. Of those who required intensive care (n=99) 72 died. The comparison of the U/A ratio was lower in survivors when compared to the dyed group on the first day of hospitalization (14.0+/-10.3 vs 22.1+/-18.8;p<0.001) and on the third day (19.1+/-16.1 vs 28.3+/-16.8;p=0.005). The absolute variation in urea on the third day from baseline was also lower in the group of survivors (1.59+/-13.8 vs 30.9+/-37.9;p<0.001). The multiple logistic regression model adjusted for age, sex, place of hospitalization and C-reactive protein showed that the U/A ratio on the first day was associated with a higher risk of mortality [OR 1.04;95%CI 1.02-1.07;p=0.002]. The U/A ratio on the third day was not associated with risk of death whereas the absolute variation in urea showed an association with mortality [OR 1.03;(95%CI 1.01-1.05);p<0.001]. Conclusion(s) the use of the U/A ratio and the urea variation can predict mortality in patients hospitalized for COVID19.