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Blood Urea Nitrogen/Albumin Ratio and Mortality Risk in Patients with COVID-19

Swarnima Singh1, Kunal Singh2

  • 1Department of Biochemistry, Netaji Subhas Medical College and Hospital, Patna, Bihar, India.

Indian Journal of Critical Care Medicine : Peer-Reviewed, Official Publication of Indian Society of Critical Care Medicine
|June 20, 2022
PubMed

Insights

Blood urea nitrogen (BUN) and albumin levels, along with their ratio (BAR), can predict in-hospital mortality in COVID-19 patients. Low albumin levels were the strongest indicator of mortality risk.

Area of Science:

  • Medical research
  • Clinical diagnostics
  • Infectious disease epidemiology

Background:

  • Predicting in-hospital mortality in COVID-19 patients is crucial for resource allocation and treatment strategies.
  • Biomarkers such as C-reactive protein (CRP) and D-dimer have been investigated for their prognostic value.
  • The utility of blood urea nitrogen (BUN), albumin, and their ratio (BAR) in predicting COVID-19 mortality requires further investigation.

Purpose of the Study:

  • To evaluate the predictive value of BUN, albumin, and BAR for in-hospital mortality in COVID-19 patients.
  • To compare the predictive performance of BUN, albumin, BAR, CRP, D-dimer, and computed tomography severity scores (CT-SS).

Main Methods:

  • A retrospective study of 131 COVID-19 patients admitted to the emergency department.
  • Patients were categorized into survivor and non-survivor groups based on in-hospital mortality.
  • Laboratory parameters including BUN, albumin, CRP, and D-dimer were analyzed, alongside CT-SS.

Main Results:

  • In-hospital mortality was observed in 32.06% of patients.
  • Non-survivors showed significantly higher BUN and BAR, and lower albumin levels compared to survivors (p < 0.0001).
  • Albumin demonstrated the highest predictive value (odds ratio [OR] = 6.14) for mortality, followed by D-dimer (OR = 4.98), BAR (OR = 3.75), CRP (OR = 3.75), and BUN (OR = 3.13).

Conclusions:

  • BUN, albumin, and BAR are reliable predictors of in-hospital mortality in COVID-19 patients.
  • Hypoalbuminemia (low albumin levels) emerged as the most potent predictor of mortality in this cohort.
  • These biomarkers can aid in risk stratification and clinical decision-making for severe COVID-19 cases.
Abstract

Keywords:
Blood urea nitrogen/albumin ratioC-reactive proteinCOVID-19COVID-19 mortalityD-dimerHypoalbuminemia

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