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2020 ; 56
(3
): 106110
Nephropedia Template TP
gab.com Text
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English Wikipedia
Diagnostic performance of initial blood urea nitrogen combined with D-dimer
levels for predicting in-hospital mortality in COVID-19 patients
#MMPMID32712332
Cheng A
; Hu L
; Wang Y
; Huang L
; Zhao L
; Zhang C
; Liu X
; Xu R
; Liu F
; Li J
; Ye D
; Wang T
; Lv Y
; Liu Q
Int J Antimicrob Agents
2020[Sep]; 56
(3
): 106110
PMID32712332
show ga
The crude mortality rate in critical pneumonia cases with coronavirus disease
2019 (COVID-19) reaches 49%. This study aimed to test whether levels of blood
urea nitrogen (BUN) in combination with D-dimer were predictors of in-hospital
mortality in COVID-19 patients. The clinical characteristics of 305 COVID-19
patients were analysed and were compared between the survivor and non-survivor
groups. Of the 305 patients, 85 (27.9%) died and 220 (72.1%) were discharged from
hospital. Compared with discharged cases, non-survivor cases were older and their
BUN and D-dimer levels were significantly higher (P < 0.0001). Least absolute
shrinkage and selection operator (LASSO) and multivariable Cox regression
analyses identified BUN and D-dimer levels as independent risk factors for poor
prognosis. Kaplan-Meier analysis showed that elevated levels of BUN and D-dimer
were associated with increased mortality (log-rank, P < 0.0001). The area under
the curve for BUN combined with D-dimer was 0.94 (95% CI 0.90-0.97), with a
sensitivity of 85% and specificity of 91%. Based on BUN and D-dimer levels on
admission, a nomogram model was developed that showed good discrimination, with a
concordance index of 0.94. Together, initial BUN and D-dimer levels were
associated with mortality in COVID-19 patients. The combination of BUN ? 4.6
mmol/L and D-dimer ? 0.845 ?g/mL appears to identify patients at high risk of
in-hospital mortality, therefore it may prove to be a powerful risk assessment
tool for severe COVID-19 patients.