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Validation of a Prospective Urinalysis-Based Prediction Model for ICU Resources and Outcome of COVID-19 Disease: A Multicenter Cohort Study

In COVID-19, guidelines recommend a urinalysis on hospital admission as SARS-CoV-2 renal tropism, post-mortem, was associated with disease severity and mortality. Following the hypothesis from our pilot study, we now validate an algorithm harnessing urinalysis to predict the outcome and the need for...

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Autores principales: Gross, Oliver, Moerer, Onnen, Rauen, Thomas, Böckhaus, Jan, Hoxha, Elion, Jörres, Achim, Kamm, Matthias, Elfanish, Amin, Windisch, Wolfram, Dreher, Michael, Floege, Juergen, Kluge, Stefan, Schmidt-Lauber, Christian, Turner, Jan-Eric, Huber, Samuel, Addo, Marylyn M., Scheithauer, Simone, Friede, Tim, Braun, Gerald S., Huber, Tobias B., Blaschke, Sabine
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8306631/
https://www.ncbi.nlm.nih.gov/pubmed/34300217
http://dx.doi.org/10.3390/jcm10143049
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author Gross, Oliver
Moerer, Onnen
Rauen, Thomas
Böckhaus, Jan
Hoxha, Elion
Jörres, Achim
Kamm, Matthias
Elfanish, Amin
Windisch, Wolfram
Dreher, Michael
Floege, Juergen
Kluge, Stefan
Schmidt-Lauber, Christian
Turner, Jan-Eric
Huber, Samuel
Addo, Marylyn M.
Scheithauer, Simone
Friede, Tim
Braun, Gerald S.
Huber, Tobias B.
Blaschke, Sabine
author_facet Gross, Oliver
Moerer, Onnen
Rauen, Thomas
Böckhaus, Jan
Hoxha, Elion
Jörres, Achim
Kamm, Matthias
Elfanish, Amin
Windisch, Wolfram
Dreher, Michael
Floege, Juergen
Kluge, Stefan
Schmidt-Lauber, Christian
Turner, Jan-Eric
Huber, Samuel
Addo, Marylyn M.
Scheithauer, Simone
Friede, Tim
Braun, Gerald S.
Huber, Tobias B.
Blaschke, Sabine
author_sort Gross, Oliver
collection PubMed
description In COVID-19, guidelines recommend a urinalysis on hospital admission as SARS-CoV-2 renal tropism, post-mortem, was associated with disease severity and mortality. Following the hypothesis from our pilot study, we now validate an algorithm harnessing urinalysis to predict the outcome and the need for ICU resources on admission to hospital. Patients were screened for urinalysis, serum albumin (SA) and antithrombin III activity (AT-III) obtained prospectively on admission. The risk for an unfavorable course was categorized as (1) “low”, (2) “intermediate” or (3) “high”, depending on (1) normal urinalysis, (2) abnormal urinalysis with SA ≥ 2 g/dL and AT-III ≥ 70%, or (3) abnormal urinalysis with SA or AT-III abnormality. Time to ICU admission or death served as the primary endpoint. Among 223 screened patients, 145 were eligible for enrollment, 43 falling into the low, 84 intermediate, and 18 into high-risk categories. An abnormal urinalysis significantly elevated the risk for ICU admission or death (63.7% vs. 27.9%; HR 2.6; 95%-CI 1.4 to 4.9; p = 0.0020) and was 100% in the high-risk group. Having an abnormal urinalysis was associated with mortality, a need for mechanical ventilation, extra-corporeal membrane oxygenation or renal replacement therapy. In conclusion, our data confirm that COVID-19-associated urine abnormalities on admission predict disease aggravation and the need for ICU (ClinicalTrials.gov number NCT04347824).
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spelling pubmed-83066312021-07-25 Validation of a Prospective Urinalysis-Based Prediction Model for ICU Resources and Outcome of COVID-19 Disease: A Multicenter Cohort Study Gross, Oliver Moerer, Onnen Rauen, Thomas Böckhaus, Jan Hoxha, Elion Jörres, Achim Kamm, Matthias Elfanish, Amin Windisch, Wolfram Dreher, Michael Floege, Juergen Kluge, Stefan Schmidt-Lauber, Christian Turner, Jan-Eric Huber, Samuel Addo, Marylyn M. Scheithauer, Simone Friede, Tim Braun, Gerald S. Huber, Tobias B. Blaschke, Sabine J Clin Med Article In COVID-19, guidelines recommend a urinalysis on hospital admission as SARS-CoV-2 renal tropism, post-mortem, was associated with disease severity and mortality. Following the hypothesis from our pilot study, we now validate an algorithm harnessing urinalysis to predict the outcome and the need for ICU resources on admission to hospital. Patients were screened for urinalysis, serum albumin (SA) and antithrombin III activity (AT-III) obtained prospectively on admission. The risk for an unfavorable course was categorized as (1) “low”, (2) “intermediate” or (3) “high”, depending on (1) normal urinalysis, (2) abnormal urinalysis with SA ≥ 2 g/dL and AT-III ≥ 70%, or (3) abnormal urinalysis with SA or AT-III abnormality. Time to ICU admission or death served as the primary endpoint. Among 223 screened patients, 145 were eligible for enrollment, 43 falling into the low, 84 intermediate, and 18 into high-risk categories. An abnormal urinalysis significantly elevated the risk for ICU admission or death (63.7% vs. 27.9%; HR 2.6; 95%-CI 1.4 to 4.9; p = 0.0020) and was 100% in the high-risk group. Having an abnormal urinalysis was associated with mortality, a need for mechanical ventilation, extra-corporeal membrane oxygenation or renal replacement therapy. In conclusion, our data confirm that COVID-19-associated urine abnormalities on admission predict disease aggravation and the need for ICU (ClinicalTrials.gov number NCT04347824). MDPI 2021-07-09 /pmc/articles/PMC8306631/ /pubmed/34300217 http://dx.doi.org/10.3390/jcm10143049 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Gross, Oliver
Moerer, Onnen
Rauen, Thomas
Böckhaus, Jan
Hoxha, Elion
Jörres, Achim
Kamm, Matthias
Elfanish, Amin
Windisch, Wolfram
Dreher, Michael
Floege, Juergen
Kluge, Stefan
Schmidt-Lauber, Christian
Turner, Jan-Eric
Huber, Samuel
Addo, Marylyn M.
Scheithauer, Simone
Friede, Tim
Braun, Gerald S.
Huber, Tobias B.
Blaschke, Sabine
Validation of a Prospective Urinalysis-Based Prediction Model for ICU Resources and Outcome of COVID-19 Disease: A Multicenter Cohort Study
title Validation of a Prospective Urinalysis-Based Prediction Model for ICU Resources and Outcome of COVID-19 Disease: A Multicenter Cohort Study
title_full Validation of a Prospective Urinalysis-Based Prediction Model for ICU Resources and Outcome of COVID-19 Disease: A Multicenter Cohort Study
title_fullStr Validation of a Prospective Urinalysis-Based Prediction Model for ICU Resources and Outcome of COVID-19 Disease: A Multicenter Cohort Study
title_full_unstemmed Validation of a Prospective Urinalysis-Based Prediction Model for ICU Resources and Outcome of COVID-19 Disease: A Multicenter Cohort Study
title_short Validation of a Prospective Urinalysis-Based Prediction Model for ICU Resources and Outcome of COVID-19 Disease: A Multicenter Cohort Study
title_sort validation of a prospective urinalysis-based prediction model for icu resources and outcome of covid-19 disease: a multicenter cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8306631/
https://www.ncbi.nlm.nih.gov/pubmed/34300217
http://dx.doi.org/10.3390/jcm10143049
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