Laboratory Predictors of COVID‐19 Mortality: A Retrospective Analysis from Tongji Hospital in Wuhan
Ting Zheng, Xinxin Liu, Yingying Wei, Xinlu Li, Bing Zheng, Quan Gong, Lingli Dong, Jixin Zhong
Abstract
Background . Novel coronavirus disease 2019 (COVID‐19), an acute respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), rapidly progressed to a global pandemic. Currently, there are limited effective medications approved for this deadly disease. Objective . To investigate the potential predictors of COVID‐19 mortality and risk factors for hyperinflammation in COVID‐19. Methods . Retrospective analysis was carried out in 1,149 patients diagnosed with COVID‐19 in Tongji Hospital, Wuhan, China, from 1/13/2020 to 3/15/2020. Results . We found significant differences in the rates of hyperuricemia (OR: 3.17, 95% CI: 2.13‐4.70; p < 0.001) and hypoalbuminemia (OR: 5.68, 95% CI: 3.97‐8.32; p < 0.001) between deceased and recovered patients. The percentages of hyperuricemia in deceased patients and recovered patients were 23.6% and 8.9%, respectively, which were higher than the reported age‐standardized prevalence of 6.2% in Chinese population. Of note, the percentages of both IL‐6 and uric acid levels in survived COVID‐19 patients were above 90%, suggesting that they might be good specificity for indicators of mortality in COVID‐19 patients. The serum level of uric acid (UA) was positively associated with ferritin, TNF‐ α , and IL‐6 but not with anti‐inflammatory cytokine IL‐10. In addition, the levels of these proinflammatory cytokines in COVID‐19 patients showed a trend of reduction after uric acid lowering therapy. Conclusions . Our results suggest that uric acid, the end product of purine metabolism, was increased in deceased patients with COVID‐19. In addition, the serum level of uric acid was positively associated with inflammatory markers. Uric acid lowering therapy in COVID‐19 patients with hyperuricemia may be beneficial.