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Uric acid as a prognostic predictor in COVID-19
Ergün Parmaksız1, Elif Torun Parmaksız2
1Ergün Parmaksız, Department of Nephrology, Kartal Dr Lutfi Kırdar City Hospital, Health Sciences University, Istanbul, Turkey.
Pakistan Journal of Medical Sciences
|November 23, 2022
Summary
Low baseline uric acid levels in COVID-19 patients correlated with increased ICU admission. A decline in uric acid during hospitalization indicated a poor prognosis for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
Area of Science:
- Infectious Diseases
- Clinical Biochemistry
- Critical Care Medicine
Background:
- COVID-19, caused by SARS-CoV-2, presents a wide spectrum of illness severity.
- Uric acid, an antioxidant, plays a role in inflammatory processes.
- The prognostic value of uric acid levels in COVID-19 remains incompletely understood.
Purpose of the Study:
- To determine the incidence of abnormal uric acid levels (hypouricemia and hyperuricemia) at baseline in COVID-19 patients.
- To investigate the association between baseline uric acid levels and COVID-19 severity, including intensive care unit (ICU) admission.
- To evaluate the prognostic significance of uric acid levels measured during the disease course and their correlation with patient outcomes.
Main Methods:
- A cohort of 498 patients diagnosed with SARS-CoV-2 infection between March 2020 and March 2021 were analyzed.
- Uric acid levels were measured at admission for all patients and at the most severe disease stage for a subset of 143 patients.
- Clinical data, including ICU admission, length of stay, and mortality, were collected and correlated with uric acid measurements.
Main Results:
- Hypouricemia was observed in 21 patients and hyperuricemia in 170 patients at admission; hypouricemia was not a predominant feature.
- Patients requiring ICU admission showed a higher incidence in the hypouricemic group (47.6%) compared to normouricemic (19.2%) and hyperuricemic (21.2%) groups.
- A significant decrease in mean uric acid levels during hospitalization was observed in patients with a negative prognosis, including those admitted to the ICU.
Conclusions:
- Hypouricemia is not a defining characteristic of SARS-CoV-2 infection.
- Lower baseline uric acid levels are associated with an increased likelihood of ICU admission in COVID-19 patients.
- A declining trend in uric acid levels throughout the hospital stay serves as a predictor of poor prognosis in COVID-19.
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