Hyperuricemia and the Severity of Coronavirus Disease 2019 in Japan: A Retrospective Cohort Study – An Inseparable Relation with Hypertension and Chronic Kidney Disease

Introduction: This study aimed to explore the impact of comorbid hyperuricemia on disease severity in Japanese patients with coronavirus disease 2019 (COVID-19). This retrospective cohort study included patients with COVID-19 between July 2020 and February 2021. Methods: We divided patients into mild, moderate, and severe groups according to the degree of disease severity. Clinical and biochemical parameters on admission and comorbidities were compared between the mild and severe groups. Results: We enrolled 146 patients in this study: 36 patients were allocated to the mild group, 96 to the moderate group, and 14 to the severe group. The male sex, age, body mass index (BMI), systolic blood pressure, pulse rate, white blood cell counts, levels of serum urea nitrogen and uric acid were significantly higher in the severe group than in the mild group (p<0.05), while lymphocyte counts and estimated glomerular filtration rate were significantly lower (p<0.05). As for comorbidities, malignant tumor, diabetes mellitus, hypertension, chronic kidney disease (CKD), hyperlipidemia, and hyperuricemia were associated with COVID-19 severity. Logistic regression analysis indicated that hyperuricemia was significantly positively associated with the severity of COVID-19 independent of age, sex, BMI, comorbidities of diabetes mellitus, and malignant tumor. However, the association between hyperuricemia and COVID-19 severity was eliminated by correction with hypertension or CKD. Conclusion: These data suggested that comorbidities of hyperuricemia may indicate an increased risk of COVID-19 progression. Furthermore, patients with hyperuricemia comorbidities may require careful and intensive multidisciplinary treatment for hyperuricemia and hypertension and/or CKD to prevent progression of COVID-19.