Can blood urea Nitrogen-to-Albumin ratio predict mortality in patients with moderate-to-severe COVID-19 pneumonia hospitalized in the intensive care unit?

Abstract

OBJECTIVE: Many laboratory parameters allow to follow up the course of the disease and reveal its clinical severity, particularly in patients with coronavirus disease 2019 (COVID-19) pneumonia. In this study, we aimed to investigate the role of the blood urea nitrogen-to-albumin ratio in predicting the mortality in COVID-19 patients with moderate-to-severe disease who are hospitalized in the intensive care unit.METHODS: A total of 358 patients who were hospitalized in intensive care unit at our hospital between November 1, 2020 and May 15, 2021 were included in this study. During their course of intensive care, surviving patients were included in Group 1 and nonsurviving patients in Group 2.RESULTS: There were no statistically significant differences between the two groups in terms of gender, smoking, and chronic obstructive pulmonary disease rates. In multivariate logistic regression analysis, advanced age (OR 1.038, 95%CI 1.014-1.064, p=0.002), neutrophilto-lymphocyte ratio (OR 1.226, 95%CI 1.020-1.475, p=0.030), blood urea nitrogen-to-albumin ratio (OR 2.693, 95%CI 2.019-3.593, p<0.001), and chest computed tomography severity score (OR 1.163, p<0.001) values were determined as independent predictors for in-hospital mortality.CONCLUSION: In this study, we showed that the blood urea nitrogen-to-albumin ratio, which was previously shown as a predictor of mortality in patients with various pneumonia, was an independent predictor of mortality in patients with COVID-19 pneumonia.

Multi-inflammatory Index as a Novel Mortality Predictor in Critically Ill COVID-19 Patients

“…Albumin based inflammatory parameters (UAR, LAR, CAR, DAR, FAR and PAR) were also studied in critical illnesses as well as COVID-19 and they were all found to be useful in the prediction of prognosis. 20 – 26 Consistent with these studies, we also found that albumin based inflammatory parameters were significantly higher in mortal cases compared with survived ones.…”

“…5 Apart from NLR, many other inflammatory parameters showing systemic inflammation were found to be useful in predicting mortality in COVID-19 patients. [19][20][21][22][23][24][25][26][27][28][29] The common mechanism of the effect of these parameters to the disease mortality is that systemic inflammation has a crucial role in the pathogenesis and mortality of COVID-19. 6,8 Hemogram based inflammatory parameters were previously investigated in COVID-19 patients.…”

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

“…3). [20][21][22][23][31][32][33] Sensitivity analysis reinforced the robustness of the result by showing no significant impact of the finding from a single study on the overall outcome. Publication bias was not investigated because only 7 studies were available.…”

“…5). [20][21][22][23]31,33] Linear regression analysis of sROC generated from mathematical computation of true and false positivity (1-specificity) of each study showed an AUC of 0.81 (95% CI = 0.77-0.84) (Fig. 6).…”

“…[18,19] Recently, several studies have also identified BUN/albumin ratio as an indicator for prognostic outcomes in patients with COVID-19. [20][21][22] Nevertheless, its efficacy for predicting in-hospital mortality based on ROC analysis varied in different observational studies with a reported area under the curve (AUC) ranging from 0.733 to 0.809. [20,23] Together with the limitation of being single-center studies in previous reports, the level of evidence supporting its clinical predictive value remains controversial.…”