Comparing the Value of Cystatin C and Serum Creatinine for Evaluating the Renal Function and Predicting the Prognosis of COVID-19 Patients
Background: Coronavirus disease- (COVID-19-) related renal function abnormality is associated with poor prognosis. However, the clinical significance of dynamic changes in renal function indicators has not been studied, and no studies have evaluated the renal function in COVID-19 patients by cystati...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-03-01
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| Series: | Frontiers in Pharmacology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2021.587816/full |
| _version_ | 1818417461746204672 |
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| author | Sichao Chen Jinpeng Li Zeming Liu Danyang Chen Ling Zhou Di Hu Man Li Wei Long Yihui Huang Jianglong Huang Shipei Wang Qianqian Li Wen Zeng Liang Guo Xiaohui Wu |
| author_facet | Sichao Chen Jinpeng Li Zeming Liu Danyang Chen Ling Zhou Di Hu Man Li Wei Long Yihui Huang Jianglong Huang Shipei Wang Qianqian Li Wen Zeng Liang Guo Xiaohui Wu |
| author_sort | Sichao Chen |
| collection | DOAJ |
| description | Background: Coronavirus disease- (COVID-19-) related renal function abnormality is associated with poor prognosis. However, the clinical significance of dynamic changes in renal function indicators has not been studied, and no studies have evaluated the renal function in COVID-19 patients by cystatin C.Objective: This study aimed to evaluate the effect of abnormal renal function on admission on prognosis of COVID-19 patients and the prognostic value of various renal function indicators.Methods: A total of 1,764 COVID-19 patients without a history of chronic kidney disease were categorized into two groups, an elevated cystatin C group and a normal cystatin C group, based on the results of renal function tests on admission. The clinical characteristics were compared between the two groups, and logistic or Cox regression analyses were performed to explore the associations between elevated cystatin C/serum creatinine levels and disease severity and survival. We also performed receiver operating characteristic (ROC) curve, Kaplan–Meier survival, and curve fitting analyses.Results: When adjusted for several significant clinical variables, elevated cystatin C levels on admission were independent predictors of disease severity (p < 0.001), and elevated creatinine levels were independent predictors of death (p = 0.020). Additionally, the ROC curve analysis shows that elevated cystatin C levels [area under the curve (AUC): 0.656] have a better predictive value for disease severity than elevated creatinine levels (AUC: 0.540). The survival curves of patients with elevated cystatin C/creatinine levels show a sharper decline than those of patients with normal cystatin C/creatinine levels (p < 0.001). The curve fitting analysis revealed that, compared to the flat curves of cystatin C and creatinine levels for patients who survived, the curves for patients who died kept rising, and cystatin C levels rose above the normal range earlier than creatinine.Conclusions: Elevated cystatin C, which occurs earlier than serum creatinine, is useful for the early detection of renal function abnormality and might have better predictive value for disease severity in COVID-19 patients, while elevated serum creatinine may have a better predictive value for risks of death. |
| first_indexed | 2024-12-14T12:07:09Z |
| format | Article |
| id | doaj.art-c97ff3e15dff428783ad54a58586452d |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-12-14T12:07:09Z |
| publishDate | 2021-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-c97ff3e15dff428783ad54a58586452d2022-12-21T23:01:50ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122021-03-011210.3389/fphar.2021.587816587816Comparing the Value of Cystatin C and Serum Creatinine for Evaluating the Renal Function and Predicting the Prognosis of COVID-19 PatientsSichao Chen0Jinpeng Li1Zeming Liu2Danyang Chen3Ling Zhou4Di Hu5Man Li6Wei Long7Yihui Huang8Jianglong Huang9Shipei Wang10Qianqian Li11Wen Zeng12Liang Guo13Xiaohui Wu14Department of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, ChinaDepartment of Thyroid and Breast Surgery, Zhongnan Hospital of Wuhan University, Wuhan, ChinaDepartment of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, ChinaDepartment of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, ChinaDepartment of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, ChinaDepartment of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, ChinaDepartment of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, ChinaDepartment of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, ChinaDepartment of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, ChinaDepartment of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, ChinaDepartment of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, ChinaDepartment of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, ChinaDepartment of Ophthalmology, Zhongnan Hospital of Wuhan University, Wuhan, ChinaDepartment of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, ChinaDepartment of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, ChinaBackground: Coronavirus disease- (COVID-19-) related renal function abnormality is associated with poor prognosis. However, the clinical significance of dynamic changes in renal function indicators has not been studied, and no studies have evaluated the renal function in COVID-19 patients by cystatin C.Objective: This study aimed to evaluate the effect of abnormal renal function on admission on prognosis of COVID-19 patients and the prognostic value of various renal function indicators.Methods: A total of 1,764 COVID-19 patients without a history of chronic kidney disease were categorized into two groups, an elevated cystatin C group and a normal cystatin C group, based on the results of renal function tests on admission. The clinical characteristics were compared between the two groups, and logistic or Cox regression analyses were performed to explore the associations between elevated cystatin C/serum creatinine levels and disease severity and survival. We also performed receiver operating characteristic (ROC) curve, Kaplan–Meier survival, and curve fitting analyses.Results: When adjusted for several significant clinical variables, elevated cystatin C levels on admission were independent predictors of disease severity (p < 0.001), and elevated creatinine levels were independent predictors of death (p = 0.020). Additionally, the ROC curve analysis shows that elevated cystatin C levels [area under the curve (AUC): 0.656] have a better predictive value for disease severity than elevated creatinine levels (AUC: 0.540). The survival curves of patients with elevated cystatin C/creatinine levels show a sharper decline than those of patients with normal cystatin C/creatinine levels (p < 0.001). The curve fitting analysis revealed that, compared to the flat curves of cystatin C and creatinine levels for patients who survived, the curves for patients who died kept rising, and cystatin C levels rose above the normal range earlier than creatinine.Conclusions: Elevated cystatin C, which occurs earlier than serum creatinine, is useful for the early detection of renal function abnormality and might have better predictive value for disease severity in COVID-19 patients, while elevated serum creatinine may have a better predictive value for risks of death.https://www.frontiersin.org/articles/10.3389/fphar.2021.587816/fullCOVID-19cystatin Ccreatininerenal functionprognosis |
| spellingShingle | Sichao Chen Jinpeng Li Zeming Liu Danyang Chen Ling Zhou Di Hu Man Li Wei Long Yihui Huang Jianglong Huang Shipei Wang Qianqian Li Wen Zeng Liang Guo Xiaohui Wu Comparing the Value of Cystatin C and Serum Creatinine for Evaluating the Renal Function and Predicting the Prognosis of COVID-19 Patients Frontiers in Pharmacology COVID-19 cystatin C creatinine renal function prognosis |
| title | Comparing the Value of Cystatin C and Serum Creatinine for Evaluating the Renal Function and Predicting the Prognosis of COVID-19 Patients |
| title_full | Comparing the Value of Cystatin C and Serum Creatinine for Evaluating the Renal Function and Predicting the Prognosis of COVID-19 Patients |
| title_fullStr | Comparing the Value of Cystatin C and Serum Creatinine for Evaluating the Renal Function and Predicting the Prognosis of COVID-19 Patients |
| title_full_unstemmed | Comparing the Value of Cystatin C and Serum Creatinine for Evaluating the Renal Function and Predicting the Prognosis of COVID-19 Patients |
| title_short | Comparing the Value of Cystatin C and Serum Creatinine for Evaluating the Renal Function and Predicting the Prognosis of COVID-19 Patients |
| title_sort | comparing the value of cystatin c and serum creatinine for evaluating the renal function and predicting the prognosis of covid 19 patients |
| topic | COVID-19 cystatin C creatinine renal function prognosis |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2021.587816/full |
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