Proteinuria as a Biomarker for COVID-19 Severity

Frontiers in Physiology

Vincent Bruckert²  Romain Lombardi⁴  Lucas Morand⁴  Hajar Ouahmi⁵  Vincent Esnault⁵  Juliette François⁶  Elisa Demonchy⁷  Sonia Boyer-Suavet⁸  Barbara Seitz-Polski⁸  Jean Dellamonica⁸  Johan Courjon⁹ 

[1] Centre de référence Maladies rares Syndrome néphrotique idiopathique, CHU de Nice, Université Côte d’Azur, Nice, France;Département de réanimation médico-chirugicale et transplantation d’organe, hôpital L’Archet 2, CHU de Nice, Université Côte d’Azur, Nice, France;Laboratoire d’Immunologie, CHU de Nice, Université Côte d’Azur, Nice, France;Service de Médecine Intensive Réanimation, CHU de Nice, Université Côte d’Azur, Nice, France;Service de Néphrologie-Dialyse-Transplantation, CHU de Nice, Université Côte d’Azur, Nice, France;Service de Réanimation CH Antibes-Juan les Pins, Antibes, France;Service d’Infectiologie, CHU de Nice, Université Côte d’Azur, Nice, France;Unité de Recherche Clinique de la Côte d’Azur (UR2CA), Université Côte d’Azur, Nice, France;Université Côte d’Azur, Centre Méditerranéen de Médecine Moléculaire (C3M), CHU de Nice, INSERM U1065, Nice, France;

关键词: acute kidney injury;    biomarker;    COVID-19;    proteinuria;    SARS-CoV-2;    kidney involvement;   

DOI  :  10.3389/fphys.2021.611772

来源: DOAJ

【 摘 要 】

BackgroundRenal involvement in syndrome coronavirus 2 (SARS-CoV-2) infection has been retrospectively described, especially acute kidney injury (AKI). However, quantitative proteinuria assessment and its implication in coronavirus disease 2019 (COVID-19) remain unknown.MethodsIn this prospective, multicenter study in France, we collected clinical and biological data including urinary protein to creatine ratio (UPCR) in patients presenting with moderate to severe COVID-19. Clinical outcome was analyzed according to the level of UPCR.Results42/45 patients (93.3%) had renal involvement (abnormal urinary sediment and/or AKI). Significant proteinuria occurred in 60% of patients. Urine protein electrophoresis showed tubular protein excretion in 83.8% of patients with proteinuria. Inflammatory parametersand D-dimer concentrations correlated with proteinuria level. Patients who required intensive care unit (ICU) admission had higher proteinuria (p = 0.008). On multivariate analysis, proteinuria greater than 0.3 g/g was related to a higher prevalence of ICU admission [OR = 4.72, IC95 (1.16–23.21), p = 0.03], acute respiratory distress syndrome (ARDS) [OR = 6.89, IC95 (1.41–53.01, p = 0.02)], nosocomial infections [OR = 3.75, IC95 (1.11–13.55), p = 0.03], longer inpatient hospital stay (p = 0.003).ConclusionRenal involvement is common in moderate to severe SARS-CoV-2 infection. Proteinuria at baseline is an independent risk factor for increased hospitalization duration and ICU admission in patients with COVID-19.

【 授权许可】

Unknown