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Baseline moderate-range albuminuria is associated with protection against severe COVID-19 pneumonia
BACKGROUND: Diabetes mellitus is considered a leading contributor to severe coronavirus disease 2019 (COVID-19). AIM: To characterize differences between hospitalized diabetic patients with vs without COVID-19, and parameters associated with COVID-19 severity for prediction. METHODS: This case-contr...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Baishideng Publishing Group Inc
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9791569/ https://www.ncbi.nlm.nih.gov/pubmed/36578868 http://dx.doi.org/10.4239/wjd.v13.i12.1154 |
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author | Bashkin, Amir Shehadeh, Mona Shbita, Lina Namoura, Kamil Haiek, Ronza Kuyantseva, Elena Boulos, Yousef Yakir, Orly Kruzel-Davila, Etty |
author_facet | Bashkin, Amir Shehadeh, Mona Shbita, Lina Namoura, Kamil Haiek, Ronza Kuyantseva, Elena Boulos, Yousef Yakir, Orly Kruzel-Davila, Etty |
author_sort | Bashkin, Amir |
collection | PubMed |
description | BACKGROUND: Diabetes mellitus is considered a leading contributor to severe coronavirus disease 2019 (COVID-19). AIM: To characterize differences between hospitalized diabetic patients with vs without COVID-19, and parameters associated with COVID-19 severity for prediction. METHODS: This case-control study included 209 patients with type 2 diabetic mellitus hospitalized at the Galilee Medical Center (Nahariya, Israel) and recruited between September 2020 and May 2021, 65 patients with COVID-19 infection in dedicated wards and 144 COVID-19-negative patients in internal medicine wards hospitalized due to other reasons. Clinical parameters - including age, type of antiglycemic medications, presence of retinopathy, smoking history, body mass index (BMI), glycosylated hemoglobin, maximum neutrophil:lymphocyte ratio (NLR(max)), C-reactive protein (CRP), estimated glomerular filtration rate (eGFR), and albumin (blood and urine) - were compared between the two primary patient groups, and then between COVID-19-negative patients hospitalized due to infectious vs non-infectious disease. Finally, we explored which parameters were associated with severe COVID-19 pneumonia. RESULTS: COVID-19-negative patients were older (63.9 ± 9.9 vs 59.8 ± 9.2, P = 0.005), and had longer duration of diabetes (P = 0.031), lower eGFR (P = 0.033), higher albumin (P = 0.026), lower CRP (P < 0.001), greater smoking prevalence (P < 0.001), and more baseline albuminuria (54.9% vs 30.8%, P = 0.005) at admission; 70% of COVID-19 patients with albuminuria had moderate-range albuminuria (albumin:creatinine 30-300 mg/g). Most of the patients with albuminuria had chronic kidney disease stage II (CKD II). Oral antiglycemic therapies were not significantly different between the two groups. Multivariable logistic regression showed that higher BMI was significantly associated with severe COVID-19 (OR 1.24, 95%CI: 1.01-1.53, P = 0.04), as was higher NLR(max) (OR 1.2, 95%CI: 1.06-1.37, P = 0.005). Surprisingly, pre-hospitalization albuminuria, mostly moderate-range, was associated with reduced risk (OR 0.09, 95%CI: 0.01-0.62, P = 0.015). Moderate-range albuminuria was not associated with bacterial infections. CONCLUSION: Moderate-range albuminuria in COVID-19-positive diabetic patients with CKD II is associated with less severe COVID-19. Further studies should explore this potential biomarker for risk of COVID-19-related deterioration and early interventions. |
format | Online Article Text |
id | pubmed-9791569 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
spelling | pubmed-97915692022-12-27 Baseline moderate-range albuminuria is associated with protection against severe COVID-19 pneumonia Bashkin, Amir Shehadeh, Mona Shbita, Lina Namoura, Kamil Haiek, Ronza Kuyantseva, Elena Boulos, Yousef Yakir, Orly Kruzel-Davila, Etty World J Diabetes Observational Study BACKGROUND: Diabetes mellitus is considered a leading contributor to severe coronavirus disease 2019 (COVID-19). AIM: To characterize differences between hospitalized diabetic patients with vs without COVID-19, and parameters associated with COVID-19 severity for prediction. METHODS: This case-control study included 209 patients with type 2 diabetic mellitus hospitalized at the Galilee Medical Center (Nahariya, Israel) and recruited between September 2020 and May 2021, 65 patients with COVID-19 infection in dedicated wards and 144 COVID-19-negative patients in internal medicine wards hospitalized due to other reasons. Clinical parameters - including age, type of antiglycemic medications, presence of retinopathy, smoking history, body mass index (BMI), glycosylated hemoglobin, maximum neutrophil:lymphocyte ratio (NLR(max)), C-reactive protein (CRP), estimated glomerular filtration rate (eGFR), and albumin (blood and urine) - were compared between the two primary patient groups, and then between COVID-19-negative patients hospitalized due to infectious vs non-infectious disease. Finally, we explored which parameters were associated with severe COVID-19 pneumonia. RESULTS: COVID-19-negative patients were older (63.9 ± 9.9 vs 59.8 ± 9.2, P = 0.005), and had longer duration of diabetes (P = 0.031), lower eGFR (P = 0.033), higher albumin (P = 0.026), lower CRP (P < 0.001), greater smoking prevalence (P < 0.001), and more baseline albuminuria (54.9% vs 30.8%, P = 0.005) at admission; 70% of COVID-19 patients with albuminuria had moderate-range albuminuria (albumin:creatinine 30-300 mg/g). Most of the patients with albuminuria had chronic kidney disease stage II (CKD II). Oral antiglycemic therapies were not significantly different between the two groups. Multivariable logistic regression showed that higher BMI was significantly associated with severe COVID-19 (OR 1.24, 95%CI: 1.01-1.53, P = 0.04), as was higher NLR(max) (OR 1.2, 95%CI: 1.06-1.37, P = 0.005). Surprisingly, pre-hospitalization albuminuria, mostly moderate-range, was associated with reduced risk (OR 0.09, 95%CI: 0.01-0.62, P = 0.015). Moderate-range albuminuria was not associated with bacterial infections. CONCLUSION: Moderate-range albuminuria in COVID-19-positive diabetic patients with CKD II is associated with less severe COVID-19. Further studies should explore this potential biomarker for risk of COVID-19-related deterioration and early interventions. Baishideng Publishing Group Inc 2022-12-15 2022-12-15 /pmc/articles/PMC9791569/ /pubmed/36578868 http://dx.doi.org/10.4239/wjd.v13.i12.1154 Text en ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. |
spellingShingle | Observational Study Bashkin, Amir Shehadeh, Mona Shbita, Lina Namoura, Kamil Haiek, Ronza Kuyantseva, Elena Boulos, Yousef Yakir, Orly Kruzel-Davila, Etty Baseline moderate-range albuminuria is associated with protection against severe COVID-19 pneumonia |
title | Baseline moderate-range albuminuria is associated with protection against severe COVID-19 pneumonia |
title_full | Baseline moderate-range albuminuria is associated with protection against severe COVID-19 pneumonia |
title_fullStr | Baseline moderate-range albuminuria is associated with protection against severe COVID-19 pneumonia |
title_full_unstemmed | Baseline moderate-range albuminuria is associated with protection against severe COVID-19 pneumonia |
title_short | Baseline moderate-range albuminuria is associated with protection against severe COVID-19 pneumonia |
title_sort | baseline moderate-range albuminuria is associated with protection against severe covid-19 pneumonia |
topic | Observational Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9791569/ https://www.ncbi.nlm.nih.gov/pubmed/36578868 http://dx.doi.org/10.4239/wjd.v13.i12.1154 |
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