Clinical and laboratory features of the course of the coronavirus disease and the level of cystatin C in hospitalized patients

Abstract

The course of coronavirus disease is often accompanied by renal dysfunction, which is the result of comorbid pathology, namely diabetes mellitus, hypertension and precisely nephrological diseases. The most common and affordable way to monitor the condition of the kidneys is by determining the level of creatinine and calculating the glomerular filtration rate. However, serum cystatin C level is the «gold standard» for assessing renal function. This study aims to examine the clinical and laboratory aspects of coronavirus disease and establish the correlation between cystatin C and kidney function in hospitalized patients. 79 patients with coronavirus disease ranging from 24 to 73 years were involved in the study. The percentage of women in the group was 40,5%, while the percentage of men was 59,5%. The current protocol for the treatment of coronavirus disease, approved in Ukraine, was followed by all patients. Additionally, to assess renal dysfunction, cystatin C was determined biochemically using the SPINREACT test system (Spain). Results. Creatinine level was 123.0 (96,0; 151,0) μmol/l. Glomerular filtration rate was 52 (42,5; 71,0) ml/h/l.73m 2 , suggesting renal dysfunction. The cystatin C concentration was 1,27 (0,81; 1,87) mg/l. Cystatin C correlated with creatinine concentration (r = 0,62, p < 0,05) and negatively correlated with GFR (r = -0,65; p < 0,05), while, unlike creatinine, its level did not depend on age and gender. Increasing the concentration of cystatin C in the future could be a prognostic marker for the severe course of coronavirus disease, not just for renal dysfunction. Conclusions. Clinical manifestations and laboratory parameters during hospital admission depended on the premorbid background and were characterized by the presence of the following syndromes: systemic inflammatory response, respiratory failure, hypercoagulation and renal dysfunction. An elevated level of cystatin C is an indicator of kidney dysfunction, as well as a prognostic marker of severe coronavirus disease.