Research Article
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Year 2022, Volume: 8 Issue: 3, 422 - 431, 31.08.2022
https://doi.org/10.19127/mbsjohs.1126040

Abstract

References

  • 1. Republic of Türkiye Ministry of Health. https://covid19.saglik.gov.tr/ (updated 2022 May 12; cited 2022 May 15)
  • 2. Kim L, Garg S, O'Halloran A, Whitaker M, Pham H, Anderson EJ, et al. Risk Factors for Intensive Care Unit Admission and In-hospital Mortality Among Hospitalized Adults Identified through the US Coronavirus Disease 2019 (COVID-19)-Associated Hospitalization Surveillance Network (COVID-NET). Clin Infect Dis. 2021 May 4;72(9):206-214.
  • 3. Piroth L, Cottenet J, Mariet AS, Bonniaud P, Blot M, Tubert-Bitter P, et al. Comparison of the characteristics, morbidity, and mortality of COVID-19 and seasonal influenza: a nationwide, population-based retrospective cohort study. Lancet Respir Med. 2021 Mar;9(3):251-259.
  • 4. Henry BM, de Oliveira MHS, Benoit S, Plebani M, Lippi G. Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): a meta-analysis. Clin Chem Lab Med. 2020 June 25;58(7):1021-1028.
  • 5. Bastug A, Bodur H, Erdogan S, Gokcinar D, Kazancioglu S, Kosovali BD, et al. Clinical and laboratory features of COVID-19: Predictors of severe prognosis. Int Immunopharmacol. 2020 Nov;88:106950.
  • 6. Yu W, Cheng JD. Uric Acid and Cardiovascular Disease: An Update From Molecular Mechanism to Clinical Perspective. Front Pharmacol. 2020 Nov 16;11:582680
  • 7. Qin T, Zhou X, Wang J, Wu X, Li Y, Wang L, et al. Hyperuricemia and the Prognosis of Hypertensive Patients: A Systematic Review and Meta-Analysis. J Clin Hypertens. (Greenwich) 2016 Dec;18(12):1268-1278.
  • 8. Konta T, Ichikawa K, Kawasaki R, Fujimoto S, Iseki K, Moriyama T, et al. association between serum uric acid levels and mortality: a nationwide community-based cohort study. Sci Rep. 2020 Apr 8;10(1):6066.
  • 9. Chang DY, Wang JW, Chen M, Zhang LX, Zhao MH. Association between serum uric acid level and mortality in China. Chin Med J. (Engl) 2021 July 27;134(17):2073-2080.
  • 10. Chauhan K, Pattharanitima P, Piani F, Johnson RJ, Uribarri J, Chan L, et al. Prevalence and Outcomes Associated with Hyperuricemia in Hospitalized Patients with COVID-19. Am J Nephrol. 2022;53(1):78-86.
  • 11. Li G, Wu X, Zhou CL, Wang YM, Song B, Cheng XB, et al. Uric acid as a prognostic factor and critical marker of COVID-19. Sci Rep. 2021 Sep 7;11(1):17791.
  • 12. Chen B, Lu C, Gu HQ, Li Y, Zhang G, Lio J, et al. Serum Uric Acid Concentrations and Risk of Adverse Outcomes in Patients With COVID-19. Front Endocrinol. (Lausanne) 2021 May 6;12:633767.
  • 13. Yang Y, Zhang X, Jin Z, Zhao Q. Association of serum uric acid with mortality and cardiovascular outcomes in patients with hypertension: a meta-analysis. J Thromb Thrombolysis. 2021 Nov;52(4):1084-1093.
  • 14. Maloberti A, Giannattasio C, Bombelli M, Desideri G, Cicero AFG, Muiesan ML, et al.; Working Group on Uric Acid and Cardiovascular Risk of the Italian Society of Hypertension (SIIA). Hyperuricemia and Risk of Cardiovascular Outcomes: The Experience of the URRAH (Uric Acid Right for Heart Health) Project. High Blood Press Cardiovasc Prev. 2020 Apr;27(2):121-128.
  • 15. Liu S, Zhong Z, Liu F. Prognostic value of hyperuricemia for patients with sepsis in the intensive care unit. Sci Rep. 2022 Jan 20;12(1):1070.
  • 16. Pehlivanlar-Kucuk M, Kucuk AO, Ozturk CE, Er MC, Ulger F. The Association Between Serum Uric Acid Level and Prognosis in Critically Ill Patients, Uric Acid as a Prognosis Predictor. Clin Lab. 2018 Sep 1;64(9):1491-1500.
  • 17. Zheng T, Liu X, Wei Y, Li X, Zheng B, Gong Q, et al. Laboratory Predictors of COVID-19 Mortality: A Retrospective Analysis from Tongji Hospital in Wuhan. Mediators Inflamm. 2021 Feb 23;2021:6687412.
  • 18. Al-Kuraishy HM, Al-Gareeb AI, Al-Niemi MS, et al. The Prospective Effect of Allopurinol on the Oxidative Stress Index and Endothelial Dysfunction in Covid-19. Inflammation. 2022 Feb 24:1-17.
  • 19. Machhi J, Herskovitz J, Senan AM, Dutta D, Nath B, Oleynikov MD, et al. The Natural History, Pathobiology, and Clinical Manifestations of SARS-CoV-2 Infections. J Neuroimmune Pharmacol. 2020 Sep;15(3):359-386.
  • 20. Rothlin RP, Vetulli HM, Duarte M, Pelorosso FG. Telmisartan as tentative angiotensin receptor blocker therapeutic for COVID-19. Drug Dev Res. 2020 Nov;81(7):768-770.
  • 21. Liu Y, Yang Y, Zhang C, Huang F, Wang F, Yuan J, et al. Clinical and biochemical indexes from 2019-nCoV infected patients linked to viral loads and lung injury. Sci China Life Sci. 2020 Mar;63(3):364-374.
  • 22. Yu MA, Sánchez-Lozada LG, Johnson RJ, Kang DH. Oxidative stress with an activation of the renin-angiotensin system in human vascular endothelial cells as a novel mechanism of uric acid-induced endothelial dysfunction. J Hypertens. 2010 Jun;28(6):1234-1242.
  • 23. Yang Y, Wang H, Kouadir M, Song H, Shi F. Recent advances in the mechanisms of NLRP3 inflammasome activation and its inhibitors. Cell Death Dis. 2019 February 12;10(2):128.
  • 24. Sánchez-Lozada LG, Lanaspa MA, Cristóbal-García M, et al. Uric acid-induced endothelial dysfunction is associated with mitochondrial alterations and decreased intracellular ATP concentrations. Nephron Exp Nephrol. 2012;121(3-4):e71-78.
  • 25. Hu F, Guo Y, Lin J, Zeng Y, Wang J, Li M, et al. Association of serum uric acid levels with COVID-19 severity. BMC Endocr Disord. 2021 May 8;21(1):97.
  • 26. Sautin YY, Johnson RJ. Uric acid: the oxidant-antioxidant paradox. Nucleosides Nucleotides Nucleic Acids. 2008 Jun;27(6):608-619.
  • 27. Dufour I, Werion A, Belkhir L, Wisniewska A, Perrot M, De Greef J, et al; CUSL COVID-19 Research Group. Serum uric acid, disease severity and outcomes in COVID-19. Crit Care. 2021 June 14;25(1):212.
  • 28. Werion A, Belkhir L, Perrot M, Schmit G, Aydin S, Chen Z,et al; Cliniques universitaires Saint-Luc (CUSL) COVID-19 Research Group. SARS-CoV-2 causes a specific dysfunction of the kidney proximal tubule. Kidney Int. 2020 Nov;98(5):1296-1307.

Effects of Uric Acid on Disease Severity and Mortality in Hospitalized Covid-19 Patients

Year 2022, Volume: 8 Issue: 3, 422 - 431, 31.08.2022
https://doi.org/10.19127/mbsjohs.1126040

Abstract

Objective: High and low uric acid (UA) levels in the general population are associated with mortality. Information on the association of UA levels with clinical outcomes in COVID-19 patients is contradictory. We investigated the relationship between UA levels and clinical endpoints in COVID-19 patients.
Methods: Laboratory and clinical parameters, including UA at the admission of hospitalized COVID-19 patients, were recorded retrospectively. Binary logistic regression analysis determined risk factors for mortality and the intensive care unit (ICU) needs.
Results: This study included 708 patients (57.1% men), and the median age was 63 (18-98) years. Two hundred and three (28.7%) patients needed ICU, and 107 (15.7%) died. Uric acid levels were significantly higher in the deceased (6.5 vs. 4.9; p<0.001). Uric acid levels were similar in patients who needed ICU and those who did not (5 vs. 5.1; p=0.348). High UA (>median value 5.1 mg/dL) group have higher mortality rate (22.4% vs. 9.5%; p<0.001). In multivariate analyses, a high UA level was a risk factor for mortality [OR 1.93 (1.08 – 3.44); p=0.026]. In addition, age [OR 1.03 (1.01 – 1.05); p=0.004], albumin [OR 0.30 (0.17 - 0.52); P<0.001], neutrophil-to-lymphocyte ratio [OR 1.04 (1.01 – 1.06); p=0.003] and procalcitonin [OR 1.06 (1.0 – 1.11); p=0.048] was associated with mortality. A high UA level was not a risk factor for ICU need (p=0.780).
Conclusion: High serum UA level affects mortality in COVID-19 patients. Risk assessment for the prognosis of patients can be made according to the UA levels at admission.

References

  • 1. Republic of Türkiye Ministry of Health. https://covid19.saglik.gov.tr/ (updated 2022 May 12; cited 2022 May 15)
  • 2. Kim L, Garg S, O'Halloran A, Whitaker M, Pham H, Anderson EJ, et al. Risk Factors for Intensive Care Unit Admission and In-hospital Mortality Among Hospitalized Adults Identified through the US Coronavirus Disease 2019 (COVID-19)-Associated Hospitalization Surveillance Network (COVID-NET). Clin Infect Dis. 2021 May 4;72(9):206-214.
  • 3. Piroth L, Cottenet J, Mariet AS, Bonniaud P, Blot M, Tubert-Bitter P, et al. Comparison of the characteristics, morbidity, and mortality of COVID-19 and seasonal influenza: a nationwide, population-based retrospective cohort study. Lancet Respir Med. 2021 Mar;9(3):251-259.
  • 4. Henry BM, de Oliveira MHS, Benoit S, Plebani M, Lippi G. Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): a meta-analysis. Clin Chem Lab Med. 2020 June 25;58(7):1021-1028.
  • 5. Bastug A, Bodur H, Erdogan S, Gokcinar D, Kazancioglu S, Kosovali BD, et al. Clinical and laboratory features of COVID-19: Predictors of severe prognosis. Int Immunopharmacol. 2020 Nov;88:106950.
  • 6. Yu W, Cheng JD. Uric Acid and Cardiovascular Disease: An Update From Molecular Mechanism to Clinical Perspective. Front Pharmacol. 2020 Nov 16;11:582680
  • 7. Qin T, Zhou X, Wang J, Wu X, Li Y, Wang L, et al. Hyperuricemia and the Prognosis of Hypertensive Patients: A Systematic Review and Meta-Analysis. J Clin Hypertens. (Greenwich) 2016 Dec;18(12):1268-1278.
  • 8. Konta T, Ichikawa K, Kawasaki R, Fujimoto S, Iseki K, Moriyama T, et al. association between serum uric acid levels and mortality: a nationwide community-based cohort study. Sci Rep. 2020 Apr 8;10(1):6066.
  • 9. Chang DY, Wang JW, Chen M, Zhang LX, Zhao MH. Association between serum uric acid level and mortality in China. Chin Med J. (Engl) 2021 July 27;134(17):2073-2080.
  • 10. Chauhan K, Pattharanitima P, Piani F, Johnson RJ, Uribarri J, Chan L, et al. Prevalence and Outcomes Associated with Hyperuricemia in Hospitalized Patients with COVID-19. Am J Nephrol. 2022;53(1):78-86.
  • 11. Li G, Wu X, Zhou CL, Wang YM, Song B, Cheng XB, et al. Uric acid as a prognostic factor and critical marker of COVID-19. Sci Rep. 2021 Sep 7;11(1):17791.
  • 12. Chen B, Lu C, Gu HQ, Li Y, Zhang G, Lio J, et al. Serum Uric Acid Concentrations and Risk of Adverse Outcomes in Patients With COVID-19. Front Endocrinol. (Lausanne) 2021 May 6;12:633767.
  • 13. Yang Y, Zhang X, Jin Z, Zhao Q. Association of serum uric acid with mortality and cardiovascular outcomes in patients with hypertension: a meta-analysis. J Thromb Thrombolysis. 2021 Nov;52(4):1084-1093.
  • 14. Maloberti A, Giannattasio C, Bombelli M, Desideri G, Cicero AFG, Muiesan ML, et al.; Working Group on Uric Acid and Cardiovascular Risk of the Italian Society of Hypertension (SIIA). Hyperuricemia and Risk of Cardiovascular Outcomes: The Experience of the URRAH (Uric Acid Right for Heart Health) Project. High Blood Press Cardiovasc Prev. 2020 Apr;27(2):121-128.
  • 15. Liu S, Zhong Z, Liu F. Prognostic value of hyperuricemia for patients with sepsis in the intensive care unit. Sci Rep. 2022 Jan 20;12(1):1070.
  • 16. Pehlivanlar-Kucuk M, Kucuk AO, Ozturk CE, Er MC, Ulger F. The Association Between Serum Uric Acid Level and Prognosis in Critically Ill Patients, Uric Acid as a Prognosis Predictor. Clin Lab. 2018 Sep 1;64(9):1491-1500.
  • 17. Zheng T, Liu X, Wei Y, Li X, Zheng B, Gong Q, et al. Laboratory Predictors of COVID-19 Mortality: A Retrospective Analysis from Tongji Hospital in Wuhan. Mediators Inflamm. 2021 Feb 23;2021:6687412.
  • 18. Al-Kuraishy HM, Al-Gareeb AI, Al-Niemi MS, et al. The Prospective Effect of Allopurinol on the Oxidative Stress Index and Endothelial Dysfunction in Covid-19. Inflammation. 2022 Feb 24:1-17.
  • 19. Machhi J, Herskovitz J, Senan AM, Dutta D, Nath B, Oleynikov MD, et al. The Natural History, Pathobiology, and Clinical Manifestations of SARS-CoV-2 Infections. J Neuroimmune Pharmacol. 2020 Sep;15(3):359-386.
  • 20. Rothlin RP, Vetulli HM, Duarte M, Pelorosso FG. Telmisartan as tentative angiotensin receptor blocker therapeutic for COVID-19. Drug Dev Res. 2020 Nov;81(7):768-770.
  • 21. Liu Y, Yang Y, Zhang C, Huang F, Wang F, Yuan J, et al. Clinical and biochemical indexes from 2019-nCoV infected patients linked to viral loads and lung injury. Sci China Life Sci. 2020 Mar;63(3):364-374.
  • 22. Yu MA, Sánchez-Lozada LG, Johnson RJ, Kang DH. Oxidative stress with an activation of the renin-angiotensin system in human vascular endothelial cells as a novel mechanism of uric acid-induced endothelial dysfunction. J Hypertens. 2010 Jun;28(6):1234-1242.
  • 23. Yang Y, Wang H, Kouadir M, Song H, Shi F. Recent advances in the mechanisms of NLRP3 inflammasome activation and its inhibitors. Cell Death Dis. 2019 February 12;10(2):128.
  • 24. Sánchez-Lozada LG, Lanaspa MA, Cristóbal-García M, et al. Uric acid-induced endothelial dysfunction is associated with mitochondrial alterations and decreased intracellular ATP concentrations. Nephron Exp Nephrol. 2012;121(3-4):e71-78.
  • 25. Hu F, Guo Y, Lin J, Zeng Y, Wang J, Li M, et al. Association of serum uric acid levels with COVID-19 severity. BMC Endocr Disord. 2021 May 8;21(1):97.
  • 26. Sautin YY, Johnson RJ. Uric acid: the oxidant-antioxidant paradox. Nucleosides Nucleotides Nucleic Acids. 2008 Jun;27(6):608-619.
  • 27. Dufour I, Werion A, Belkhir L, Wisniewska A, Perrot M, De Greef J, et al; CUSL COVID-19 Research Group. Serum uric acid, disease severity and outcomes in COVID-19. Crit Care. 2021 June 14;25(1):212.
  • 28. Werion A, Belkhir L, Perrot M, Schmit G, Aydin S, Chen Z,et al; Cliniques universitaires Saint-Luc (CUSL) COVID-19 Research Group. SARS-CoV-2 causes a specific dysfunction of the kidney proximal tubule. Kidney Int. 2020 Nov;98(5):1296-1307.
There are 28 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Research articles
Authors

Ercan Türkmen 0000-0001-5445-4735

Ahmet Karataş 0000-0001-9095-6054

Yusuf Taha Gullu 0000-0001-8165-234X

Publication Date August 31, 2022
Published in Issue Year 2022 Volume: 8 Issue: 3

Cite

Vancouver Türkmen E, Karataş A, Gullu YT. Effects of Uric Acid on Disease Severity and Mortality in Hospitalized Covid-19 Patients. Mid Blac Sea J Health Sci. 2022;8(3):422-31.

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