Blood Urea Nitrogen to Serum Albumin Ratio (BAR) Predicts Critical Illness in Patients with Coronavirus Disease 2019 (COVID-19)

Huang, Dong; Yang, Huan; He, Yu; Wang, Ting; Zhu, Chengliang; Liang, Zongan; Yao, Rong

doi:10.2147/ijgm.s326204

Cited by 26 publications

(29 citation statements)

References 33 publications

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“…In recent years, blood urea nitrogen to albumin ratio (B/A) has been discovered to be an important prognostic biomarker, combining urea nitrogen with albumin, two important predictors. Previously, studies on the prognosis of disease based on B/A have focused primarily on lung diseases, such as pneumonia [ 9 , 23 , 24 ], pulmonary embolism [ 10 ], and lung cancer [ 25 ], and it has been established that elevated B/A had a high predictive value for mortality. The recent studies have also demonstrated that elevated B/A may play a role in prognosticating chronic heart failure [ 11 ], Escherichia coli bacteremia [ 26 ], and gastrointestinal bleeding [ 27 ], which also broaden our perspective.…”

Section: Discussionmentioning

confidence: 99%

The correlation study between blood urea nitrogen to serum albumin ratio and prognosis of patients with sepsis during hospitalization

Min

Zhong

et al. 2022

BMC Anesthesiol

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Background Sepsis is a common critical illness in intensive care unit (ICU) and seriously threatens the life of patients. Therefore, to identify a simple and effective clinical indicator to determine prognosis is essential for the management of sepsis patients. This study was mainly based on blood urea nitrogen to albumin ratio (B/A), a comprehensive index, to explore its correlation with the prognosis of sepsis patients during hospitalization. Methods Totally, adult patients in ICU who were diagnosed with sepsis in Medical Information Mart for Intensive Care IV(MIMIC-IV) database from 2008 to 2019 were involved in this study. The study population were divided into survivors group and non-survivors group based on the prognosis during hospitalization. Restricted cubic spline (RCS) was utilized to analyze the association between B/A level and the risk of ICU all-cause mortality in patients with sepsis and determine the optimal cut-off value of B/A. The study population was divided into low B/A group and high B/A group based on the optimal cut-off value. The survival curve of ICU cumulative survival rate was draw through Kaplan–Meier method. The correlation between B/A and the prognosis of patients was conducted by multivariate Cox regression analysis. Furthermore, we performed sensitivity analyses to assess the robustness of the results. Results A total of 10,578 patients with sepsis were enrolled, and the ICU all-cause mortality was 15.89%. The patients in the non-survivors group had higher B/A values and more comorbidities than those in the survivors group. RCS showed that the risk of ICU all-cause mortality increased with the B/A level, showing a non-linear trend (χ2 = 66.82, p < 0.001). The mortality rate in the high B/A group was significantly higher than that in the low B/A group (p < 0.001). Kaplan–Meier curves revealed that compared with the low B/A group, the ICU cumulative survival rate of patients with sepsis was significantly lower in the high B/A group (log-rank test, χ2 = 148.620, p < 0.001). Further analysis of multivariate Cox proportional hazards regression showed that an elevated B/A (≥ 7.93) was an independent factor associated with ICU mortality among patients with sepsis. Conclusions An elevated B/A might be a useful prognostic indicator in patients with sepsis. This study could offer a deeper insight into treating sepsis.

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Section: Discussionmentioning

confidence: 99%

The correlation study between blood urea nitrogen to serum albumin ratio and prognosis of patients with sepsis during hospitalization

Min

Zhong

et al. 2022

BMC Anesthesiol

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“…Finally, a quantitative synthesis was conducted on 7 studies involving 3600 patients that were published between 2020 and 2021. [20][21][22][23][31][32][33]…”

Section: Study Selectionmentioning

confidence: 99%

“…An overview of the characteristics of the observational reports can be found in Table 1. Studies were conducted in 4 countries throughout the world, including the following: Turkey (3 studies), [21,23,31] China (2 studies), [22,32] India (1 study), [33] and Iran (1 study). [20] Six studies recruited inpatients without mention the units to which they were admitted, [20,22,23,[31][32][33] while 1 study exclusively investigated intensive care unit (ICU) patients.…”

Section: Study Characteristics and Quality Of Studiesmentioning

confidence: 99%

“…Studies were conducted in 4 countries throughout the world, including the following: Turkey (3 studies), [21,23,31] China (2 studies), [22,32] India (1 study), [33] and Iran (1 study). [20] Six studies recruited inpatients without mention the units to which they were admitted, [20,22,23,[31][32][33] while 1 study exclusively investigated intensive care unit (ICU) patients. [21] The exclusion criteria for participants are summarized in Table S1, Supplemental Digital Content, http:// links.lww.com/MD/I496.…”

Section: Study Characteristics and Quality Of Studiesmentioning

confidence: 99%

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Efficacy of blood urea nitrogen-to-albumin ratio for predicting prognostic outcomes of inpatients with COVID-19: A meta-analysis

Hung

Huang

et al. 2023

Medicine

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Background: The associations between blood urea nitrogen (BUN)/albumin ratio and poor prognosis in patients with diagnosis of coronavirus disease 2019 (COVID-19) remain to be clarified.Methods: A search based on 4 electronic databases (i.e., EMBASE, Google scholar, MEDLINE, and Cochrane Library) was performed on June 23, 2022. The association of BUN/Albumin ratio with poor prognostic outcomes, defined as patients with mortality/severe illnesses, were analyzed.Results: Results from analysis of 7 cohort studies (3600 individuals with COVID-19) published between 2020 and 2022 showed a higher BUN/Albumin ratio in the poor-prognosis group (Mean difference: = 2.838, 95% confidence interval: 2.015-3.66, P < .001, I 2 = 92.5%) than the good-prognosis group. Additional investigation into the connection between BUN/Albumin ratio as a binary variable (i.e., high or low) and the risk of poor outcome also supported an association between a higher BUN/Albumin ratio and a poor prognostic risk (odd ratio = 3.009, 95% confidence interval: 1.565-5.783, P = .001, I 2 = 93.7%, 5 studies). Merged analysis of poor prognosis produced a sensitivity of 0.76, specificity of 0.72, and area under curve of 0.81. Conclusion:This meta-analysis demonstrated a positive correlation between BUN/albumin ratio and poor outcome in patients with COVID-19. Additional large-scale prospective studies are needed to verify our findings.Abbreviations: AUC = area under curve, BUN = blood urea nitrogen, CI = confidence interval, COVID-19 = coronavirus disease 2019, OR = odds ratio, sROC = summary receiver operating characteristic.

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“…Збільшення концентрації сечовини може відображати складний взаємозв'язок між станом харчування, білковим обміном і функціонуванням нирок пацієнтів. З літератури відомо, що SARS-CoV-2 може активувати ренін-ангіотензин-альдостерон та викликати ниркову вазоконстрикцію, уповільнення канальцевого потоку та гіпофільтрацію ниркових клубочків, що призводить до зниження виведення сечовини і підвищення всмоктування води та іонів натрію у ниркових канальцях і пасивної реабсорбції сечовини [23,24]. Відповідно до цього ми припускаємо, що зростання концентрації сечовини в переважній більшості груп донорів пов'язане з негативним впливом SARS-CoV-2 на функціонування нирок, що спричиняє зміни водно-сольового та білкового балансу в організмі.…”

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BIOCHEMICAL PARAMETERS OF KIDNEY FUNCTION IN DONORS UNDER THE PRESENCE OF ANTI-SARS-CoV-2 IgG IN BLOOD

Krenytska¹,

Rachkovska²,

Savchuk³

et al. 2022

BTSNUKSB

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Pandemic caused by SARS-CoV-2 virus in the world influences negatively on economic and social life, health care system. Conctracted COVID-19 patients suffered from outcome this disease after recovery because of SARS-CoV-2 has affected system disorder of body. Problems of digestion, blood coagulation, humoral and nervous systems could be discovered background disorder of respiratory system working. Besides, the clinical researches agree the changes of functioning kidneys in hospitalized patients suffered by SARS-CoV-2 virus. Therefore the pathological status of kidneys could develop in post-COVID-19 period. Our research is aimed to analysis of changes of concentration albumin, creatinine, urea and urea acid in blood plasma of donors with different titers of anti-SARS-CoV-2 IgG. Groups of donors were selected, in which the maximum and minimum values of the studied parameters were observed relative to the control group - donors without anti-SARS-CoV-2 IgG in blood. We determined that donor group with minimum titer of anti-SARS-CoV-2 IgG – 10 ± 3 Index (S/C) – have been characterized the maximum concentration of creatinine, urea and urea acid. Moreover the donor group with titer of anti-SARS-CoV-2 IgG 75 ± 5 Index (S/C) had the minimum concentration of albumin, creatinine, urea and urea acid. Obtained results could be linked with the potential influence of SARS-CoV-2 virus to kindey cells and consequents of immune response to infection caused by COVID-19 disease. Our research could be useful for treatment of COVID-19, which would involve the clinical therapy aimed not only at neutralizing the virus in the body, but also at reducing the negative load on the kidneys to prevent the development of pathological conditions in the post-COVID-19 period.

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Blood Urea Nitrogen to Serum Albumin Ratio (BAR) Predicts Critical Illness in Patients with Coronavirus Disease 2019 (COVID-19)

Cited by 26 publications

References 33 publications

The correlation study between blood urea nitrogen to serum albumin ratio and prognosis of patients with sepsis during hospitalization

The correlation study between blood urea nitrogen to serum albumin ratio and prognosis of patients with sepsis during hospitalization

Efficacy of blood urea nitrogen-to-albumin ratio for predicting prognostic outcomes of inpatients with COVID-19: A meta-analysis

BIOCHEMICAL PARAMETERS OF KIDNEY FUNCTION IN DONORS UNDER THE PRESENCE OF ANTI-SARS-CoV-2 IgG IN BLOOD

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