A risk score based on procalcitonin for predicting acute kidney injury in COVID-19 patients

Acute kidney injury (AKI) has been reported developing commonly in coronavirus disease 2019 (COVID-19) patients and could increase the risk of poor outcomes in these patients. We design this study to explore the value of serum procalcitonin (PCT) on predicting AKI and construct risk score for predicting AKI in COVID-19 patients.

Patients diagnosed with COVID-19 and hospitalized in Renmin Hospital of Wuhan University between January 30 and February 24, 2020, were included. The least absolute shrinkage and selection operator (LASSO) regression was performed to identify the strongest predictors of AKI. Multivariate logistic regression analysis was conducted to find independent risk factors for AKI and construct risk score using odds ratio (OR) value of those risk factors. Receiver operating characteristics (ROC) curves were plotted, and area under the ROC curve (AUC) value was calculated to evaluate the predictive value of single PCT level and the constructed risk score.

Among 389 included COVID-19 patients, 28 (7.2%) patients developed AKI. LASSO regression showed hypertension, saturation of arterial oxygen (SaO₂ ), PCT, and blood urea nitrogen (BUN) were the strongest predictors for AKI. After multivariate logistic regression analysis, only SaO₂ (<0.001), PCT (p = 0.004), and BUN (p = 0.005) were independently associated with development of AKI in COVID-19 patients. The AUC of single PCT and constructed risk score was 0. 881 and 0.928, respectively.

PCT level is correlated with AKI in COVID-19 patients. The efficient risk score consisted of SaO₂ , PCT, and BUN is readily accessible for physicians to evaluate the possibility of AKI in COVID-19 patients.