Department of Cardiology, Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey.
Eur Rev Med Pharmacol Sci. 2023 Mar;27(5):2127-2131. doi: 10.26355/eurrev_202303_31584.
The impact of COVID-19 infection still continues all over the world and is an important cause of mortality. The mortality rate due to infection varies between 1-5%. The mortality rate is higher in those with cardiovascular risk factors, especially in cases with hypertension. Some studies have shown that blood urea nitrogen (BUN) and albumin levels are associated with worse prognosis in patients with COVID-19. In our study, we aimed to investigate whether the BUN/albumin (BAR) ratio has an effect on in-hospital mortality in hypertensive COVID-19 patients.
A total of 800 hypertensive COVID-19 patients, (618 of whom were alive and 182 died) were included in our study. Patients with a history of heart failure, malignancy, acute coronary syndrome, and myocarditis were excluded.
The median age of the study population was 69 (60-77 IQR) years, and 305 (38%) of these patients were men. There was no statistically significant difference between the patients who died during follow-up and cases that remained alive in terms of comorbidities except chronic obstructive pulmonary disease (COPD) which was significantly lower in surviving group (p=0.014). Multivariable logistic regression analysis revealed that age [OR: 1.04, CI (1.01-1.06); p=0.002], male gender [OR: 1.85, CI (1.13-3.02); p=0.010], lymphocyte count [OR: 0.63, CI (0.40-0.98); p=0.038], SaO2 [OR: 0.82, CI (0.79-0.85); p<0.001] and BAR level [OR: 1.09, CI (1.04-1.16); p=0.001] were independent predictors of in-hospital mortality. ROC analysis yielded that BAR is a better predictor of in-hospital mortality compared to albumin and BUN alone.
BUN, albumin, and BAR levels were found to be reliable predictors of in-hospital mortality in COVID-19 patients, and BAR was also found to be a more reliable predictor than BUN and albumin levels. Hypertension is one of the major risk factors for morbidity and mortality in COVID-19 and, BAR presents additional prognostic data in hypertensive COVID-19 patients that may direct physicians for treatment intensification.
新冠病毒感染的影响仍在全球范围内持续，并成为导致死亡的一个重要原因。感染导致的死亡率在 1-5%之间。在有心血管危险因素的人群中，死亡率更高，尤其是高血压患者。一些研究表明，血尿素氮（BUN）和白蛋白水平与 COVID-19 患者的预后较差有关。在我们的研究中，我们旨在探讨 BUN/白蛋白（BAR）比值是否对高血压合并 COVID-19 患者的住院死亡率有影响。
我们共纳入了 800 例高血压合并 COVID-19 患者（其中 618 例存活，182 例死亡）。排除有心力衰竭、恶性肿瘤、急性冠脉综合征和心肌炎病史的患者。
研究人群的中位年龄为 69 岁（60-77 IQR），其中 305 例（38%）为男性。在随访期间死亡的患者与存活的患者在合并症方面除慢性阻塞性肺疾病（COPD）外，无统计学差异，而 COPD 在存活组中明显较低（p=0.014）。多变量逻辑回归分析显示，年龄[比值比（OR）：1.04，95%置信区间（CI）：1.01-1.06；p=0.002]、男性[OR：1.85，CI：1.13-3.02；p=0.010]、淋巴细胞计数[OR：0.63，CI：0.40-0.98；p=0.038]、SaO2[OR：0.82，CI：0.79-0.85；p<0.001]和 BAR 水平[OR：1.09，CI：1.04-1.16；p=0.001]是住院死亡率的独立预测因素。ROC 分析表明，BAR 是 COVID-19 患者住院死亡率的更好预测指标，优于单独的白蛋白和 BUN。
BUN、白蛋白和 BAR 水平是 COVID-19 患者住院死亡率的可靠预测指标，BAR 也是比 BUN 和白蛋白水平更可靠的预测指标。高血压是 COVID-19 患者发病率和死亡率的主要危险因素之一，BAR 为高血压合并 COVID-19 患者提供了额外的预后数据，可能有助于医生进行治疗强化。
