Blood Urea Nitrogen/Albumin Ratio and Mortality Risk in Patients with COVID-19
S Singh, Swarnima Singh
Abstract
We researched blood urea nitrogen (BUN), albumin and their ratio (BAR), and compared them with C-reactive protein (CRP), D-dimer, and computed tomography severity scores (CT-SS), to predict inhospital mortality. Methods: One-hundred and thirty-one coronavirus disease-2019 (COVID-19)-confirmed patients brought to the emergency department (ED) were dispensed to the survivor or non-survivor group, in light of inhospital mortality. Information on age, gender, complaints, comorbidities, laboratory parameters, and outcome were gathered from the patient's record files. Results: The median BUN, mean total protein, mean albumin, median BAR, median creatinine, median CRP, and median D-dimer were recorded. CT-SS were utilized in categorizing the patient as mild, moderate, and severe. Inhospital mortality occurred in 42 (32.06%) patients (non-survivor group) and did not occur in 89 (67.94%) patients (survivor group). The median BUN (mg/dL) and BAR (mg/g) values were significantly raised in the non-survivor group than in the survivor group [BUN: 23.48 (7.51-62.75) and 20.66 (4.07-74.67), respectively (p = 0.009); BAR: 8.33 mg/g (2.07-21.86) and 6.11 mg/g (1.26-23.33); (p = 0.0003)]. The mean albumin levels (g/dL) in the non-survivor group were significantly lower than in the survivor group [2.96 0.35 and 3.27 0.35, respectively (p <0.0001)]. Albumin with an odd's ratio of 6.14 performed the best in predicting inhospital mortality, followed by D-dimer (4.98). BAR and CRP had similar outcome of 3.75; BUN showed an OR of 3.13 at the selected cutoff value.