Regional High Speciality Hospital of the Yucatan Peninsula, Mexico.
Regional High Speciality Hospital of the Yucatan Peninsula, Mexico.
Braz J Infect Dis. 2022 May-Jun;26(3):102365. doi: 10.1016/j.bjid.2022.102365. Epub 2022 May 6.
Patients infected with SARS-CoV-2 can develop acute kidney injury (AKI), associated with adverse clinical outcomes. In Mexico, an AKI incidence of 60.7% was reported in patients with COVID-19. Serum cystatin C is a well-known marker for AKI. It has been postulated as a marker for mortality in Chinese patients with COVID-19. Information regarding levels of cystatin C in COVID-19-infected patients is nonexistent among Mexican or Latin American populations.
This work aimed to assess the level of cystatin C as an indicator of AKI and mortality among COVID-19 patients from Mexico.
A cross-sectional study among 38 adults was performed in the Regional High Specialty Hospital of the Yucatan Peninsula in Merida, Yucatan, Mexico. Baseline characteristics and clinical and biomechanical parameters were collected, and serum levels of cystatin C were measured by ELISA.
A total of 71% (27 patients) with COVID-19 developed AKI; 78% were men, and 22% were women. In addition, 60% of individuals (16 men; 7 women) died due to COVID-19 complications. Serum levels of cystatin C were higher in those individuals who developed AKI (p = 0.001). A logistic regression model indicated that individuals with serum levels of cystatin C above 0.84 ng/mL had a 23-fold increased risk of developing AKI (OR, 23.7, 95% CI, 2.59-217.00, p = 0.005). However, increased cystatin C was not independently associated with mortality in the Mexican population (HR, 1.01, 95% CI, 0.66-1.56, p = 0.959).
The results suggest that serum levels of cystatin C indicate AKI in COVID-19 patients. Although we recommend caution when using serum cystatin C levels as an indicator of mortality among the Mexican population, it is essential to note that cystatin C elevates earlier than creatinine, which is an advantage for timely clinical interventions.
感染 SARS-CoV-2 的患者可能会发生急性肾损伤（AKI），并伴有不良临床结局。在墨西哥，有研究报道 COVID-19 患者的 AKI 发病率为 60.7%。血清胱抑素 C 是 AKI 的一个已知标志物。有研究提出，它是中国 COVID-19 患者死亡的一个标志物。然而，墨西哥或拉丁美洲人群中，并无关于 COVID-19 感染患者胱抑素 C 水平的信息。
本研究旨在评估血清胱抑素 C 作为墨西哥 COVID-19 患者 AKI 和死亡率的标志物。
在墨西哥尤卡坦半岛梅里达的地区高专科医院进行了一项横断面研究，共纳入 38 例成年人。收集了基线特征和临床及生物力学参数，并通过 ELISA 法测定血清胱抑素 C 水平。
COVID-19 患者中共有 71%（27 例）发生 AKI；78%为男性，22%为女性。此外，60%（16 例男性；7 例女性）的患者因 COVID-19 并发症而死亡。发生 AKI 的患者血清胱抑素 C 水平更高（p=0.001）。逻辑回归模型表明，血清胱抑素 C 水平高于 0.84ng/mL 的个体发生 AKI 的风险增加 23 倍（比值比，23.7，95%置信区间，2.59-217.00，p=0.005）。然而，在墨西哥人群中，升高的胱抑素 C 与死亡率无独立相关性（HR，1.01，95%置信区间，0.66-1.56，p=0.959）。
结果表明，血清胱抑素 C 水平提示 COVID-19 患者发生 AKI。虽然我们建议在墨西哥人群中使用血清胱抑素 C 水平作为死亡率的指标时要谨慎，但需要注意的是，胱抑素 C 的升高早于肌酐，这对于及时进行临床干预具有优势。
