Are high urea values before intravenous immunoglobulin replacement a risk factor for COVID-related mortality?

Abstract

Objective: Since the World Health Organization accepted The Coronavirus Disease 2019 (COVID-19) as a pandemic and there is still no effective treatment, it becomes crucial that the physicians interested in COVID-19 treatment share all the data they acquire, particularly in vulnerable patient groups, to reduce morbidity and mortality. Methods: The study included 81 adults (Female: 27, Male: 54) COVID-19 patients who were hospitalized for the treatment of COVID-19 between April 2020 and September 2020 and were followed-up, treated, and consulted in the immunology clinic for intravenous immunoglobulin (IVIG) treatment. Results: The univariate analysis found that the number of days of hospitalization in service, being intubated, number of IVIG treatment days, and the urea value before IVIG treatment were independent risk factors for mortality (p:0.043, p:0.001, p:0.074, p:0.004, respectively). As a result of multivariate analysis, being intubated and urea value before IVIG treatment were found to be independent risk factors for mortality (p:0.001 and p:0.009). It was found that for 60 mg/dL level of urea value before IVIG treatment, the sensitivity value for mortality in COVID-19 patients was 46.2%, and the specificity was 35.5% (p:0.029) Conclusion: The study found that urea values before IVIG treatment were a risk factor for mortality in patients who received IVIG treatment for COVID-19. This is important as it indicates that BUN values should be closely monitored in patients given IVIG treatment for COVID-19. It also suggests that when resources are limited and risk stratification is required in COVID-19 patients, BUN values can be helpful. Keywords: SARS-CoV-2, immunoglobulin, mortality, blood urea nitrogen, COVID-19