A new cystatin C based model for predicting COVID-19- associated mortality

Year 2022, Volume: 3 Issue: 2, 126 - 132, 31.05.2022

Sümeyra Koyuncu , Serhat Koyuncu , Halil İbrahim Akdoğan , Mehmet Kara Göksel Güven , Didem Barlak Keti Hilal Sipahioğlu , Gözde Ertürk Zararsız , İsmail Koçyiğit , Bülent Tokgöz

Abstract

Background: This study aimed to investigate the effect of the Cystatin C based model on kidney function and the value of this model on predicting mortality in patients with the recent novel coronavirus disease (COVID-19).

Methods: Demographic characteristics, clinical manifestations, and laboratory measurements were measured in critically ill patients with COVID-19 infection. Patients were monitored until they were discharged from the hospital or died.

Results: 105 patients participated in this study. 29 of 105 patients were treated in the intensive care unit. Acute kidney injury developed in nearly all of these patients and developed in 6 other non-intensive care unit patients. 21 of the patients in the intensive care unit had exitus.

Conclusion: The cystatin C (sCys C )based model may be used to predict mortality in severe COVID-19 infections.

Keywords

Acute kidney injury, Cystatin-C, mortality

References

• 1. Hirsch JS, Ng JH, Ross DW, Northwell COVID-19 Research Consortium; Northwell Nephrology COVID-19 Research Consortium. Acute kidney injury in patients hospitalized with COVID-19. Kidney Int 2020; 98: 209-218
• 2. Guven G, Ince C, Topeli A. Cardio-Pulmonary-Renal Consequences of Severe COVID-19. Cardiorenal Med. 2021;11(3):133-139.
• 3. Laterza OF, Price CP, Scott MG. Cystatin C: an improved estimator of glomerular filtration rate? Clin Chem. 2002;48(5):699-707.
• 4. Dharnidharka VR, Kwon C, Stevens G. Serum cystatin C is superior to serum creatinine as a marker of kidney function: a meta-analysis. Am J Kidney Dis. 2002;40:221–6.
• 5. Roos JF, Doust J, Tett SE. Diagnostic accuracy of cystatin C compared to serum creatinine for the estimation of renal dysfunction in adults and children a meta-analysis. Clin Biochem. 2007;40:383–91.
• 6. Shlipak MG, Sarnak MJ, Katz R. Cystatin C and the risk of death and cardiovascular events among elderly persons. N Engl J Med. 2005;352:2049–60. 7. Ni L, Lü J, Hou LB. Cystatin C, associated with hemorrhagic and ischemic stroke, is a strong predictor of the risk of cardiovascular events and death in Chinese. Stroke. 2007; 38:3287–8.
• 8. World Health Organization, Clinical management of severe acute respiratory infection when novel coronavirus (2019- nCoV) infection is suspected: interim guidance, World Health Organization, 2020, Published January 2020.
• 9. Pei G, Zhang Z, Peng J. Renal Involvement and Early Prognosis in Patients with COVID-19 Pneumonia. J Am Soc Nephrol. 2020;31(6):1157-1165
• 10. Eknoyan G, Lameire N, Eckardt K. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidny Int Suppl. 2013;3(1):1-150.
• 11. Mathisen UD, Melsom T, Ingebretsen OC. Estimated GFR associates with cardio vascular risk factors independently of measured GFR. J Am Soc Nephrol. 2011;22(5):927-937.
• 12. Wu CK, Lin JW, Caffrey JL. Cystatin C and long-term mortality among subjects with nor- mal creatinine-based estimated glomerular filtration rates: NHANES III (Third National Health and Nutrition Examination Survey). J Am Coll Cardiol. 2010;56(23):1930-6.
• 13. Schöttker B, Herder C, Müller H, Rothenbacher D. Clinical utility of creatinine-and cystatin C-based definition of renal function for risk prediction of primary cardio- vascular events in patients with diabetes. Diabetes Care. 2012;35(4):879-86.
• 14. Nejat M, Pickering JW, Walker RJ. Rapid detection of acute kidney injury by plasma cystatin C in the intensive care unit. Nephrol Dial Transplant, 2010;3283-3289.
• 15. Roos JF, Doust J, Tett SE. Diagnostic accuracy of cystatin C compared to serum creatinine for the estimation of renal dysfunction in adults and children: a meta-analysis. Clin Biochem. 2007;40(5–6):383-391.
• 16. Yildirim C, Ozger HS, Yasar E. Early predictors of acute kidney injury in COVID-19 patients. Nephrology (Carlton). 2021 Jan 27.
• 17. Tay MZ, Poh CM, Rénia L.“The trinity of COVID-19: immunity, inflammation and intervention,” Nature Reviews Immunology, 2020;20:6:363– 374.
• 18. Conti P, Ronconi G, Caraffa AL “Induction of proinflammatory cytokines (IL-1 and IL-6) and lung inflammation by coronavirus-19 (COVI-19 or SARS-CoV-2): anti- inflammatory strategies,” Journal of Biological Regulators and Homeostatic Agents, vol. 2020;34:2:1.
• 19. Wang D, Hu B, Hu C. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan. China JAMA. 2020;323:1061–9.
• 20. Zhou F, Yu T, Du R. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395:1054–62.
• 21. Ouyang SM, Zhu HQ, Xie YN. Temporal changes in laboratory markers of survivors and non-survivors of adult inpatients with COVID-19. BMC Infect Dis. 2020;11;20(1):952.
• 22. Akbari H, Tabrizi R, Lankarani KB. The role of cytokine profile and lymphocyte subsets in the severity of coronavirus disease 2019 (COVID-19): a systematic review and meta-analysis. Life Sci. 2020;258:118167.
• 23. Ghahramani S, Tabrizi R, Lankarani KB. Laboratory features of severe vs. non-severe COVID-19 patients in Asian populations: a systematic review and meta-analysis. Eur J Med Res. 2020;25:30.
• 24. Li Y, Yang S, Peng D, Zhu HM. Predictive value of serum cystatin C for risk of mortality in severe and critically ill patients with COVID-19. World J Clin Cases. 2020 Oct 26;8(20):4726-4734.
• 25. Chen D, Sun W, Li J. Serum Cystatin C and Coronavirus Disease 2019: A Potential Inflammatory Biomarker in Predicting Critical Illness and Mortality for Adult Patients. Mediators Inflamm. 2020 Oct 8;2020:3764515
• 26. Bell M, Granath F, Martensson J. Cystatin C is correlated with mortality in patients with and without acute kidney injury. Nephrol Dial Transplant 2009; 24:3096 – 3102.
• 27. Henry BM, de Oliveira MHS, Benoit S. Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID- 19): a meta-analysis. Clin Chem Lab Med 2020; 58: 1021-1028
• 28. Su H, Yang M, Wan C. Renal histopathological analysis of 26 postmortem findings of patients with COVID-19 in China. Kidney Int 2020; 98: 219-227
• 29. Xiang J, Wen J, Yuan X. Potential biochemical markers to identify severe cases among COVID-19 patients. 2020 Preprint. Available from: medRxiv:2020;03:19:20034447
• 30. Huang C, Wang Y, Li X, Ren L. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395: 497-506
• 31. Chen N, Zhou M, Dong X. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020; 395: 507-513
• 32. Delanaye P, Cavalier E, Morel J. Detection of decreased glomerular filtration rate in intensive care units: serum cystatin C versus serum creatinine. BMC Nephrol 2014; 15: 9
• 33. Pei G, Zhang Z, Peng J. Renal Involvement and Early Prognosis in Patients with COVID-19 Pneumonia. J Am Soc Nephrol 2020; 31: 1157-1165
• 34. Akerfeldt T, Helmersson J, Larsson A. Postsurgical inflammatory response is not associated with increased serum cystatin C values. Clin Biochem 2010; 43: 1138-1140
• 35. Li Y, Yang S, Peng D. Predictive value of serum cystatin C for risk of mortality in severe and critically ill patients with COVID-19. World J Clin Cases. 2020 Oct 26;8(20):4726-4734
• 36. Yildirim C, Ozger HS, Yasar E. Early predictors of acute kidney injury in COVID-19 patients. Nephrology (Carlton). 2021 Jan 27. Epub ahead of print
• 37. Gupta S, Coca SG, Chan L. AKI Treated with Renal Replacement Therapy in Critically Ill Patients with COVID-19. J Am Soc Nephrol. 2021 Jan;32(1):161-176.
• 38. Chen D, Sun W, Li J. Serum Cystatin C and Coronavirus Disease 2019: A Potential Inflammatory Biomarker in Predicting Critical Illness and Mortality for Adult Patients. Mediators Inflamm. 2020 Oct 8;2020:3764515.