The value of urine biochemical parameters in the prediction of the severity of coronavirus disease 2019

Li, Rui; Ma, Qingfeng; Han, Hyung Soo; Su, Hexiu; Liu, Fang; Wu, Kailang; Wang, Wei; Zhu, Chengliang

doi:10.1515/cclm-2020-0220

Cited by 86 publications

(112 citation statements)

References 15 publications

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“…Clinical, laboratory, imaging, and prognostic studies as well as disease outcome analysis builds up the core knowledge necessary for any new disease. Several questions in the context of COVID-19 have been addressed including spectrum of disease severity (asymptomatic to fatal) 28…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, in most studies patients with positive urine for COVID-19 were in severe clinical disease or needed oxygen supplement. On the other hand, no association has been reported between urinary symptoms and presence of virus in urine 2 while some investigators have reported a positive association between urine analysis and clinical severity of illness28 . The presence of proteinuria and microscopic hematuria has been associated with greater clinical severity of COVID-19 disease31 .…”

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confidence: 99%

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Urinary viral shedding of COVID-19 and its clinical associations: A Systematic Review and Meta-analysis of Observational Studies

Kashi

Rosette

Amini

et al. 2020

Preprint

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Purpose: To investigate the literature on the presence of COVID-19 virus in urine of infected patients and evaluate the attributes and clinical significance of COVID-19 in urine including probability of infection transmission through urine. Data sources: A systematic review of literature from December 2019 to 6 th May 2020 was conducted on Pubmed, google scholar, ovid, scopus and ISI web of science. Study eligibility criteria: Studies which investigated urinary viral shedding of COVID-19 in infected patients were included. Study appraisal and synthesis methods: Two reviewers selected relative studies and performed quality assessment of individual studies. Meta-analysis was performed the pooled case reports and case series. Fixed-effects model was used for analysis as no significant heterogeneity was observed between studies. Results: Thirty three studies were finally included in the systematic review including 12 case reports, 20 case series, and one cohort. Urinary samples from 430 patients were investigated. Ten studies reported the presence of COVID-19 in urinary samples from 16 patients. The rate of COVID-19 presence in urinary samples was 3.7%. Urinary viral load was low in most reports. The presence of virus in urine was not related to the disease course of the illness. Urinary COVID-19 was mostly detected from patients with moderate to severe disease (13 pts) but was also isolated from two children (one neonate and one 7 year-old girl) and one adult with mild disease. The pathogenicity of virus isolated from urine has been demonstrated in cell culture media in one study. Conclusions: This review highlights the low frequency of COVID-19 presence in urine of infected individuals and the potential of isolated virus for cytopathic effects. Therefore the probability of infection transmission through urine can be suggested. Caution must be exerted when dealing with urine of patients infected with COVID-19 including medical interventions like endoscopy and urethral catheterization. : medRxiv preprint ABSTRACT Purpose: To investigate the literature on the presence of COVID-19 virus in urine of infected patients and evaluate the attributes and clinical significance of COVID-19 in urine including probability of infection transmission through urine. Data sources: A systematic review of literature from December 2019 to 6 th May 2020 was conducted on Pubmed, google scholar, ovid, scopus and ISI web of science. Study eligibility criteria: Studies which investigated urinary viral shedding of COVID-19 in infected patients were included. Study appraisal and synthesis methods: Two reviewers selected relative studies and performed quality assessment of individual studies. Meta-analysis was performed the pooled case reports and case series. Fixed-effects model was used for analysis as no significant heterogeneity was observed between studies.Results: Thirty three studies were finally included in the systematic review including 12 case reports, 20 case series, and one cohort. Urinary samples from 430 patients were investigated...

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Urinary viral shedding of COVID-19 and its clinical associations: A Systematic Review and Meta-analysis of Observational Studies

Kashi

Rosette

Amini

et al. 2020

Preprint

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“…Evaluation of Covid-19 severity and possible outcomes is limited by clinical heterogeneity and lack of speci c markers [1][2][3] Several laboratory parameters are considered in clinical practice, but the identi cation of novel indicators in blood specimens is a key issue for understanding the underlying biological mechanisms and improving prognostic accuracy [4][5][6][7][8][9] As a candidate marker we focused on the S100B protein, which is regarded to be involved in in ammatory processes as a Danger-Associated Molecular Patterns (DAMP) molecule [10,11]. S100B is a small acidic calcium-binding protein, originally isolated in the nervous system, where it is concentrated in astrocytes, being also present in oligodendrocytes, Schwann cells, enteric glial cells, and some neuron subpopulations [12,13].…”

Section: Introductionmentioning

confidence: 99%

Serum S100B protein as a marker of severity in Covid-19 patients

Aceti

Margarucci

Scaramucci

et al. 2020

Preprint

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SARS-CoV-2 infection shows a wide-ranging clinical severity, requiring prognostic markers. We focused on S100B, a calcium-binding protein present in biological fluids, being a reliable biomarker in disorders having inflammatory processes as common basis and RAGE as main receptor. Since Covid-19 is characterized by a potent inflammatory response also involving RAGE, we tested if S100B serum levels were related to disease severity.Serum samples (n=74) were collected from hospitalized SARS-CoV-2 positive patients admitted to Covid center. Illness severity was established by admission clinical criteria and Covid risk score. Treatment protocols followed WHO guidelines available at the time. Circulating S100B was determined by ELISA assay. Statistical analysis used Pearson’s χ2 test, t-Test, and ANOVA, ANCOVA, Linear Regression.S100B was detected in serum from Covid-19 patients, significantly correlating with disease severity as shown both by the level of intensity of care (p<0.006) as well by the value of Covid score (Multiple R-squared: 0.3751); the correlation between Covid-Score and S100B was 0.61 (p<0.01). S100B concentration was associated with inflammation markers (Ferritin, C-Reactive Protein, Procalcitonin), and organ damage markers (Alanine Aminotransferase, Creatinine). Serum S100B plays a role in Covid-19 and can represent a prognostic marker in Sars-CoV-2 infected patients.

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“…One additional study looked at a combined outcome of disease severity and mortality. (18), (19), (20), (21), (22), (23), (24), (25), (26), (27), (28), (29), (30), (31), (32), (33), (34), (35), (36), (37), (38), (39), (40), (41), (42), (43), (44), (45), (46), (47), (48), (49), (50)…”

Section: Resultsmentioning

confidence: 99%

Informing the public health response to COVID-19 (and lessons learnt for future pandemics): a systematic review of risk factors for disease, severity, and mortality.

Flook

Jackson

Vasileiou

et al. 2020

Preprint

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BackgroundSevere Acute Respiratory Syndrome coronavirus-2 (SARS-CoV-2) has challenged public health agencies globally. In order to effectively target government responses, it is critical to identify the individuals most at risk of coronavirus disease-19 (COVID-19), developing severe clinical signs, and mortality. We undertook a systematic review of the literature, to present the current status of scientific knowledge in these areas and describe the need for unified global approaches, moving forwards, as well as lessons learnt for future pandemics. MethodsMedline, Embase and Global Health were searched to the end of April 2020, as well as the Web of Science. Search terms were specific to the SARS-CoV-2 virus and COVID-19. Comparative studies of risk factors from any setting, population group and in any language were included. Titles, abstracts and full texts were screened by two reviewers and extracted in duplicate into a standardised form. Data were extracted on risk factors for COVID-19 disease, severe disease, or death and were narratively and descriptively synthesised. Results1,238 papers were identified post-deduplication. 33 met our inclusion criteria, of which 26 were from China. Six assessed the risk of contracting the disease, 20 the risk of having severe disease and ten the risk of dying. Age, gender and co-morbidities were commonly assessed as risk factors. The weight of evidence showed increasing age to be associated with severe disease and mortality, and general comorbidities with mortality. Only seven studies presented multivariable analyses and power was generally limited. A wide range of definitions were used for disease severity. ConclusionsThe volume of literature generated in the short time since the appearance of SARS-CoV-2 has been considerable. Many studies have sought to document the risk factors for COVID-19 disease, disease severity and mortality; age was the only risk factor based on robust studies and with a consistent body of evidence. Mechanistic studies are required to understand why age is such an important risk factor. At the start of pandemics, large, standardised, studies that use multivariable analyses are urgently needed so that the populations most at risk can be rapidly protected. This review was registered on PROSPERO as CRD42020177714.

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The value of urine biochemical parameters in the prediction of the severity of coronavirus disease 2019

Cited by 86 publications

References 15 publications

Urinary viral shedding of COVID-19 and its clinical associations: A Systematic Review and Meta-analysis of Observational Studies

Urinary viral shedding of COVID-19 and its clinical associations: A Systematic Review and Meta-analysis of Observational Studies

Serum S100B protein as a marker of severity in Covid-19 patients

Informing the public health response to COVID-19 (and lessons learnt for future pandemics): a systematic review of risk factors for disease, severity, and mortality.

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