Are high urea values before intravenous immunoglobulin replacement a risk factor for COVID-related mortality?

  1. Gökhan Aytekіn
  2. Emel Atayik

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Abstract

Objective

S ince the World Health Organization accepted The Coronavirus Disease 2019 (COVID-19) as a pandemic and there is still no effective treatment, it becomes crucial that the physicians interested in COVID-19 treatment share all the data they acquire, particularly in vulnerable patient groups, to reduce morbidity and mortality.

Methods

The study included 81 adult (Female: 27, Male: 54) COVID-19 patients who were hospitalized for the treatment of COVID-19 between April 2020 and September 2020 and were followed-up, treated and consulted in the immunology clinic for intravenous immunoglobulin (IVIG) treatment.

Results

The univariate analysis found that the number of days of hospitalization in service, being intubated, number of IVIG treatment days, and the urea value before IVIG treatment were independent risk factors for mortality (p:0.043, p:0.001, p:0.074, p:0.004, respectively). As a result of multivariate analysis, being intubated and urea value before IVIG treatment were found to be independent risk factors for mortality (p:0.001 and p:0.009).

It was found that for 60 mg/dL level of urea value before IVIG treatment, the sensitivity value for mortality in COVID-19 patients was 46.2%, and the specificity was 35.5% (p:0.029)

Conclusion

The study found that urea values before IVIG treatment were a risk factor for mortality in patients who received IVIG treatment for COVID-19. This is important as it indicates that BUN values should be closely monitored in patients given IVIG treatment for COVID-19. It also suggests that when resources are limited and risk stratification is required in COVID-19 patients, BUN values can be helpful.

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  1. ScreenIT

    SciScore for 10.1101/2022.01.29.22270080: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: In addition, an ethics committee approval was obtained from Karatay University Ethics Committee (with the decision dated 09.02.2021, decision number: 2020/021).
    Consent: Written informed consent was obtained from each patient.
    Sex as a biological variableStudy design and study population: The study included 81 adult (Female [F]: 27, 33.3%; Male [M]: 54, 66.7%) COVID-19 patients who were hospitalized for the treatment of COVID-19 in a tertiary referral hospital between April 2020 and September 2020 and were followed-up, treated and consulted in the immunology clinic for IVIG treatment.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Statistical Analyses: Statistical analyses were performed using the SPSS version 22.0 software package (IBM Corp., Armonk, NY, USA).
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    The retrospective design, relatively small study population, lack of evaluation of other renal markers such as proteinuria and hematuria, and lack of knowledge of what happened in the post-follow-up period form the main limitations of this study.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2022.01.29.22270080v1 on medRxiv