Iranian Journal of Pathology

Urine Biochemical Parameters in Predicting Severity of SARS-CoV-2 Infection: an Experience in Tertiary Care Centre in Western India

Document Type : Original Research

Authors

Priyanka Sangappa Murgod 1
Preeti Rajeev Doshi 2
Ravindra C Nimbargi 2

1 Department of Pathology, Maharashtra Institute of Medical Education and Research (MIMER), Talegaon Dabhade, Pune, India

2 Department of Pathology, Bharati Vidyapeeth (DTU) Medical College and Hospital, Pune, India

https://doi.org/10.30699/ijp.2021.136576.2496
Abstract
Background & Objective: Coronavirus is an enveloped RNA virus that mainly causes respiratory infection. Real-time reverse transcriptase polymerase chain reaction (RT-PCR) test of nasopharyngeal and oropharyngeal swab is the confirmatory diagnostic test for severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection. The relationship between SARS-COV-2 and body fluid parameters is still not known. There have been few studies regarding the correlation between urine biochemical parameters and SARS-COV-2 infection. The aim of the study is to determine the importance of urinary biochemical parameters in SARS-COV-2 infection and whether these parameters can be used to predict the severity of the infection.
Methods: This was a retrospective observational study consisting of total of 285 patients diagnosed with SARS-COV-2 infection. The patients were divided into three groups according to the severity of infection as mild (120 cases), moderate (110 cases) and severe (55 cases). During the study period 72 healthy persons were enrolled as controls. Analysis was done to find any relationship between various urine biochemical parameters and the severity of SARS-COV-2 infection.
Results: Urinary occult blood (U. Blood) and Urinary protein (U. Pro) have higher positive rates in SARS-COV-2 patients as compared with healthy controls. Among the severities of SARS-COV-2 infection (mild, moderate and severe), both these parameters were significantly higher. Glucose (Glu) and Ketone (Ket) positivity rate was more in moderate cases of SARS-COV-2 than mild cases.
Conclusion: Urinary biochemical parameters are very useful in identification of SARS-COV-2 infection and also have the advantage in evaluating the progression in patients infected with SARS-COV-2. Among the different parameters, Urinary Occult Blood and Urinary protein are significant in the differentiation of SARS-COV-2 severity.

Keywords

Blood
Protein
SARS-COV-2
Urinary biochemical parameters

Subjects

  1. Liu R, Ma Q, Han H, Su H, Liu F, Wu K et al. The value of urine biochemical parameters in the prediction of the severity of coronavirus disease 2019. Clin Chem Lab Med (CCLM). 2020 Apr 14;1. [DOI:10.1515/cclm-2020-0220] [PMID]
  2. Mumm JN, Osterman A, Ruzicka M, Stihl C, Vilsmaier T, Munker D et al. Urinary Frequency as a Possibly Overlooked Symptom in COVID-19 Patients: Does SARS-CoV-2 Cause Viral Cystitis?. Europ Urol. 2020 May 19. [DOI:10.1016/j.eururo.2020.05.013] [PMID] [PMCID]
  3. Coronavirus disease (COVID-2019) situation reports. 2020; Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports.
  4. Ahn DG, Shin HJ, Kim MH, Lee S, Kim HS, Myoung J, et al. Current Status of Epidemiology, Diagnosis, Therapeutics, and Vaccines for Novel Coronavirus Disease 2019 (COVID-19). J Microbiol Biotechnol. 2020;30(3):313-24. [DOI:10.4014/jmb.2003.03011] [PMID]
  5. Adhikari SP, Meng S, Wu YJ, Mao YP, Ye RX, Wang QZ, et al. Epidemiology, causes, clinical manifestation and diagnosis, prevention and control of coronavirus disease (COVID-19) during the early outbreak period: a scoping review. Infect Dis Pov. 2020;9(1):29. [DOI:10.1186/s40249-020-00646-x] [PMID] [PMCID]
  6. Kashi AH, Fallah-karkan M, Amini E, Vaezjalali M. The Presence of COVID-19 in Urine: A Systematic Review and Meta-analysis of the Literature. medRxiv. 2020 Jan 1.
  7. Yuki K, Fujiogi M, Koutsogiannaki S. COVID-19 pathophysiology: A review. Clin Immunol. 2020 Apr 20:108427. [DOI:10.1016/j.clim.2020.108427] [PMID] [PMCID]
  8. Bonetti G, Manelli F, Bettinardi A, Borrelli G, Fiordalisi G, Marino A et al. Urinalysis parameters for predicting severity in coronavirus disease 2019 (COVID-19). Clin Chem Lab Med (CCLM). 2020 Jun 2;1. [DOI:10.1515/cclm-2020-0576] [PMID]
  9. Devillé WL, Yzermans JC, Van Duijn NP, Bezemer PD, Van Der Windt DA et al. The urine dipstick test useful to rule out infections. A meta-analysis of the accuracy. BMC Urol. 2004 Dec 1;4(1):4. [DOI:10.1186/1471-2490-4-4] [PMID] [PMCID]
  10. Peng L, Liu J, Xu W, Luo Q, Deng K, Lin B et al. 2019 Novel Coronavirus can be detected in urine, blood, anal swabs and oropharyngeal swabs samples. medRxiv. 2020 Jan 1. [DOI:10.1101/2020.02.21.20026179]
  11. Chatterjee K, Chatterjee K, Kumar A, Shankar S. Healthcare impact of COVID-19 epidemic in India: A stochastic mathematical model. Med J Armed Forces India. 2020 Apr 2. [DOI:10.1016/j.mjafi.2020.03.022] [PMID] [PMCID]
  12. Chen L, Liu W, Zhang Q, Xu K, Ye G, Wu W et al. RNA based mNGS approach identifies a novel human coronavirus from two individual pneumonia cases in 2019 Wuhan outbreak. Emerg Microbes Infect. 2020 Jan 1;9(1):313-9 [DOI:10.1080/22221751.2020.1725399] [PMID] [PMCID]
  13. Udugama B, Kadhiresan P, Kozlowski HN, Malekjahani A, Osborne M, Li VYC, et al. Diagnosing COVID-19: The Disease and Tools for Detection. ACS Nano. 2020;14(4):3822-35. [DOI:10.1021/acsnano.0c02624] [PMID] [PMCID]
  14. Wu A, Peng Y, Huang B, Ding X, Wang X, Niu P, et al. Genome Composition and Divergence of the Novel Coronavirus (2019-nCoV) Originating in China. Cell Host Microbe. 2020;27(3):325-8. https://doi.org/10.1016/j.chom.2021.02.016 [DOI:10.1016/j.chom.2020.02.001] [PMCID]
  15. Li W, Sui J, Huang IC, Kuhn JH, Radoshitzky SR, Marasco WA et al. The S proteins of human coronavirus NL63 and severe acute respiratory syndrome coronavirus bind overlapping regions of ACE2. Virology. 2007 Oct 25;367(2):367-74. [DOI:10.1016/j.virol.2007.04.035] [PMID] [PMCID]
  16. Maggo S, Dhull P, Dubey AP. Cytokine Storm Syndrome in COVID-19: Diagnosis and Management Strategies. Int J Health Sci Res. 2020;10(5):140-9.
  17. Singhal T. A review of coronavirus disease-2019 (COVID-19). Indian J Ped. 2020 Mar 13:1-6. [DOI:10.1007/s12098-020-03263-6] [PMID] [PMCID]
  18. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. Jama. 2020 Mar 17;323(11):1061-9. [DOI:10.1001/jama.2020.1585] [PMID] [PMCID]
  19. Zheng S, Fan J, Yu F, Feng B, Lou B, Zou Q et al. Viral load dynamics and disease severity in patients infected with SARS-CoV-2 in Zhejiang province, China, January-March 2020: retrospective cohort study. bmj. 2020 Apr 21;369. [DOI:10.1136/bmj.m1443] [PMID] [PMCID]
  20. Puliatti S, Eissa A, Eissa R, Amato M, Mazzone E, Dell’Oglio P, Sighinolfi MC, Zoeir A, Micali S, Bianchi G, Patel V. COVID‐19 and urology: a comprehensive review of the literature. BJU Int. 2020 Jun;125(6):E7-14. [DOI:10.1111/bju.15071] [PMID]
  21. Yao H, Zhang N, Zhang R, Duan M, Xie T, Pan J, et al. Severity detection for the coronavirus disease 2019 (COVID-19) patients using a machine learning model based on the blood and urine tests. Frontiers in cell and developmental biology. 2020 Jul 31;8:683. [DOI:10.2139/ssrn.3564426]
  22. Cheng Y, Luo R, Wang K, Zhang M, Wang Z, Dong L, et al. Kidney impairment is associated with in-hospital death of COVID-19 patients. MedRxiv. 2020 Jan 1. [DOI:10.1101/2020.02.18.20023242]
  23. Naicker S, Yang CW, Hwang SJ, Liu BC, Chen JH, Jha V. The novel coronavirus 2019 epidemic and kidneys. Kidney Int. 2020 May 1;97(5):824-8. [DOI:10.1016/j.kint.2020.03.001] [PMID] [PMCID]
  24. Zou X, Chen K, Zou J, Han P, Hao J, Han Z. Single-cell RNA-seq data analysis on the receptor ACE2 expression reveals the potential risk of different human organs vulnerable to 2019-nCoV infection. Front Med. 2020 Mar 12:1-8. [DOI:10.1007/s11684-020-0754-0] [PMID] [PMCID]
  25. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. Jama. 2020 Apr 7;323(13):1239-42. DOI: 10.1001/jama.2020.2648. [DOI:10.1001/jama.2020.2648] [PMID]
  26. Tetro JA. Is COVID-19 receiving ADE from other coronaviruses?. Microbes Infect. 2020 Mar 1;22(2):72-3. [DOI:10.1016/j.micinf.2020.02.006] [PMID] [PMCID]
  27. Zou X, Chen K, Zou J, Han P, Hao J, Han Z. Single-cell RNA-seq data analysis on the receptor ACE2 expression reveals the potential risk of different human organs vulnerable to 2019-nCoV infection. Front Med. 2020 Mar 12:1-8. [DOI:10.1007/s11684-020-0754-0] [PMID] [PMCID]
  28. Henry BM, Lippi G. Chronic kidney disease is associated with severe coronavirus disease 2019 (COVID-19) infection. Int Urol Nephrol. 2020 Jun;52(6):1193-4. [DOI:10.1007/s11255-020-02451-9] [PMID] [PMCID]
  29. Henry BM, De Oliveira MH, Benoit S, Plebani M, Lippi G. Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): a meta-analysis. Clin Chem Lab Med (CCLM). 2020 Jun 25;58(7):1021-8. [DOI:10.1515/cclm-2020-0369] [PMID]
  30. Lippi G, Plebani M. The critical role of laboratory medicine during coronavirus disease 2019 (COVID-19) and other viral outbreaks. Clin Chem Lab Med (CCLM). 2020 Jun 25;58(7):1063-9. [DOI:10.1515/cclm-2020-0240] [PMID]
Iranian Journal of Pathology
Volume 16, Issue 3
Summer 2021
Pages 304-309

  • Receive Date 16 September 2020
  • Revise Date 04 October 2020
  • Accept Date 19 October 2020

Home

Guide for Authors

Submit Manuscript

Contact Us