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Mohtasham F, Pourhoseingholi M, Hashemi Nazari SS, Kavousi K, Zali MR. Comparative analysis of feature selection techniques for COVID-19 dataset. Sci Rep 2024; 14:18627. [PMID: 39128991 PMCID: PMC11317481 DOI: 10.1038/s41598-024-69209-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 08/01/2024] [Indexed: 08/13/2024] Open
Abstract
In the context of early disease detection, machine learning (ML) has emerged as a vital tool. Feature selection (FS) algorithms play a crucial role in ensuring the accuracy of predictive models by identifying the most influential variables. This study, focusing on a retrospective cohort of 4778 COVID-19 patients from Iran, explores the performance of various FS methods, including filter, embedded, and hybrid approaches, in predicting mortality outcomes. The researchers leveraged 115 routine clinical, laboratory, and demographic features and employed 13 ML models to assess the effectiveness of these FS methods based on classification accuracy, predictive accuracy, and statistical tests. The results indicate that a Hybrid Boruta-VI model combined with the Random Forest algorithm demonstrated superior performance, achieving an accuracy of 0.89, an F1 score of 0.76, and an AUC value of 0.95 on test data. Key variables identified as important predictors of adverse outcomes include age, oxygen saturation levels, albumin levels, neutrophil counts, platelet levels, and markers of kidney function. These findings highlight the potential of advanced FS techniques and ML models in enhancing early disease detection and informing clinical decision-making.
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Affiliation(s)
- Farideh Mohtasham
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - MohamadAmin Pourhoseingholi
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research Center, University of Nottingham, Nottingham, UK
| | - Seyed Saeed Hashemi Nazari
- Department of Epidemiology, School of Public Health & Safety, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran
| | - Kaveh Kavousi
- Laboratory of Complex Biological Systems and Bioinformatics (CBB), Department of Bioinformatics, Institute of Biochemistry and Biophysics (IBB), University of Tehran, Tehran, Iran.
| | - Mohammad Reza Zali
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Nam KW, Kwon HM, Jeong HY, Park JH, Min K. Blood urea nitrogen to albumin ratio is associated with cerebral small vessel diseases. Sci Rep 2024; 14:4455. [PMID: 38396162 PMCID: PMC10891149 DOI: 10.1038/s41598-024-54919-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 02/18/2024] [Indexed: 02/25/2024] Open
Abstract
Blood urea nitrogen (BUN) to albumin ratio (BAR) is a comprehensive parameter that reflects renal, inflammatory, nutritional, and endothelial functions. BAR has been shown to be associated with various cancers, pneumonia, sepsis, and pulmonary and cardiovascular diseases; however, few studies have been conducted on its association with cerebrovascular diseases. In this study, we evaluated the association between BAR and cerebral small vessel disease (cSVD) in health check-up participants. We assessed consecutive health check-up participants between January 2006 and December 2013. For the cSVD subtype, we quantitatively measured the volume of white matter hyperintensity (WMH) and qualitatively measured the presence of lacune and cerebral microbleeds (CMBs). The BAR was calculated by dividing BUN by albumin as follows: BAR = BUN (mg/dl)/albumin (g/dl). A total of 3012 participants were evaluated. In multivariable linear regression analysis, BAR showed a statistically significant association with WMH volume after adjusting for confounders [β = 0.076, 95% confidence interval (CI): 0.027-0.125]. In multivariable logistic regression analyses, BAR was significantly associated with lacunes [adjusted odds ratio (aOR) = 1.20, 95% CI: 1.00-1.44] and CMBs (aOR = 1.28, 95% CI: 1.06-1.55). BAR was associated with all types of cSVD in the health check-up participants.
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Affiliation(s)
- Ki-Woong Nam
- Department of Neurology, Seoul National University College of Medicine, Seoul, Korea
- Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, 20 Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061, South Korea
| | - Hyung-Min Kwon
- Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.
- Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, 20 Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061, South Korea.
| | - Han-Yeong Jeong
- Department of Neurology, Seoul National University College of Medicine, Seoul, Korea
| | - Jin-Ho Park
- Department of Family Medicine, Seoul National University College of Medicine and Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea.
| | - Kyungha Min
- Department of Family Medicine, Seoul National University College of Medicine and Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea
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Yin J, Wang Y, Jiang H, Wu C, Sang Z, Sun W, Wei J, Wang W, Liu D, Huang H. Blood urea nitrogen and clinical prognosis in patients with COVID-19: A retrospective study. Medicine (Baltimore) 2024; 103:e37299. [PMID: 38394490 PMCID: PMC10883624 DOI: 10.1097/md.0000000000037299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 01/24/2024] [Accepted: 01/26/2024] [Indexed: 02/25/2024] Open
Abstract
The aim of this study was to estimate the association between blood urea nitrogen (BUN) and clinical prognosis in patients with COVID-19. A multicenter, retrospective study was conducted in adult patients with COVID-19 in 3 hospitals in Zhenjiang from January 2023 to May 2023. Patients were divided into survival and death group based on whether they survived at day 28. The demographic, comorbidities, and laboratory data were independently collected and analyzed, as well as clinical outcomes. Total 141 patients were enrolled and 23 (16.3%) died within 28 days. Patients who died within 28 days had a higher level of BUN compared with survivors. Bivariate logistic regression analysis showed that BUN was a risk factor for 28-day mortality in patients with COVID-19. ROC curve showed that BUN could predict 28-day mortality of COVID-19 patients (AUC = 0.796, 95%CI: 0.654-0.938, P < .001). When the cutoff value of BUN was 7.37 mmol/L, the sensitivity and specificity were 84.62% and 70.31%. Subgroup analysis demonstrated that hyper-BUN (≥7.37 mmol/L) was associated with increased 28-day mortality among COVID-19 patients. Patients with COVID-19 who died within 28 days had a higher level of BUN, and hyper-BUN (≥7.37 mmol/L) was associated with increased 28-day mortality.
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Affiliation(s)
- Jiangtao Yin
- Department of Critical Care Medicine, Digestive Disease Institute of Jiangsu University, Affiliated Hospital of Jiangsu University, Zhenjiang, People’s Republic of China
| | - Yuchao Wang
- Medical School of Jiangsu University, Zhenjiang, People’s Republic of China
| | - Hongyan Jiang
- Department of Cardiology, Danyang People’s Hospital, Zhenjiang, People’s Republic of China
| | - Caixia Wu
- Medical School of Jiangsu University, Zhenjiang, People’s Republic of China
| | - Ziyi Sang
- Medical School of Jiangsu University, Zhenjiang, People’s Republic of China
| | - Wen Sun
- Department of Critical Care Medicine, Jurong Hospital Affiliated to Jiangsu University, Zhenjiang, People’s Republic of China
| | - Junfei Wei
- Department of Critical Care Medicine, Traditional Chinese Medicine Hospital of Zhenjiang, Zhenjiang, People’s Republic of China
| | - Wenli Wang
- Department of Critical Care Medicine, Digestive Disease Institute of Jiangsu University, Affiliated Hospital of Jiangsu University, Zhenjiang, People’s Republic of China
| | - Dadong Liu
- Department of Critical Care Medicine, Digestive Disease Institute of Jiangsu University, Affiliated Hospital of Jiangsu University, Zhenjiang, People’s Republic of China
- Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing Medical University, Nanjing, People’s Republic of China
| | - Hanpeng Huang
- Department of Pulmonary and Critical Care Medicine, Affiliated Hospital of Jiangsu University, Zhenjiang, People’s Republic of China
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Ling-Hu T, Simons LM, Dean TJ, Rios-Guzman E, Caputo MT, Alisoltani A, Qi C, Malczynski M, Blanke T, Jennings LJ, Ison MG, Achenbach CJ, Larkin PM, Kaul KL, Lorenzo-Redondo R, Ozer EA, Hultquist JF. Integration of individualized and population-level molecular epidemiology data to model COVID-19 outcomes. Cell Rep Med 2024; 5:101361. [PMID: 38232695 PMCID: PMC10829796 DOI: 10.1016/j.xcrm.2023.101361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 08/07/2023] [Accepted: 12/11/2023] [Indexed: 01/19/2024]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants with enhanced transmissibility and immune escape have emerged periodically throughout the coronavirus disease 2019 (COVID-19) pandemic, but the impact of these variants on disease severity has remained unclear. In this single-center, retrospective cohort study, we examined the association between SARS-CoV-2 clade and patient outcome over a two-year period in Chicago, Illinois. Between March 2020 and March 2022, 14,252 residual diagnostic specimens were collected from SARS-CoV-2-positive inpatients and outpatients alongside linked clinical and demographic metadata, of which 2,114 were processed for viral whole-genome sequencing. When controlling for patient demographics and vaccination status, several viral clades were associated with risk for hospitalization, but this association was negated by the inclusion of population-level confounders, including case count, sampling bias, and shifting standards of care. These data highlight the importance of integrating non-virological factors into disease severity and outcome models for the accurate assessment of patient risk.
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Affiliation(s)
- Ted Ling-Hu
- Department of Medicine, Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; Center for Pathogen Genomics and Microbial Evolution, Northwestern University Havey Institute for Global Health, Chicago, IL 60611, USA
| | - Lacy M Simons
- Department of Medicine, Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; Center for Pathogen Genomics and Microbial Evolution, Northwestern University Havey Institute for Global Health, Chicago, IL 60611, USA
| | - Taylor J Dean
- Department of Medicine, Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; Center for Pathogen Genomics and Microbial Evolution, Northwestern University Havey Institute for Global Health, Chicago, IL 60611, USA
| | - Estefany Rios-Guzman
- Department of Medicine, Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; Center for Pathogen Genomics and Microbial Evolution, Northwestern University Havey Institute for Global Health, Chicago, IL 60611, USA
| | - Matthew T Caputo
- Havey Institute for Global Health, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Arghavan Alisoltani
- Department of Medicine, Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; Center for Pathogen Genomics and Microbial Evolution, Northwestern University Havey Institute for Global Health, Chicago, IL 60611, USA
| | - Chao Qi
- Clinical Microbiology Laboratory, Department of Pathology, Northwestern Memorial Hospital, Chicago, IL 60611, USA
| | - Michael Malczynski
- Clinical Microbiology Laboratory, Department of Pathology, Northwestern Memorial Hospital, Chicago, IL 60611, USA
| | - Timothy Blanke
- Diagnostic Molecular Biology Laboratory, Northwestern Memorial Hospital, Chicago, IL 60611, USA
| | - Lawrence J Jennings
- Clinical Microbiology Laboratory, Department of Pathology, Northwestern Memorial Hospital, Chicago, IL 60611, USA
| | - Michael G Ison
- Department of Medicine, Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Chad J Achenbach
- Department of Medicine, Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; Havey Institute for Global Health, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Paige M Larkin
- Department of Molecular Microbiology, Northshore University HealthSystem, Evanston, IL 60201, USA
| | - Karen L Kaul
- Department of Pathology, Northshore University HealthSystem, Evanston, IL 60201, USA
| | - Ramon Lorenzo-Redondo
- Department of Medicine, Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; Center for Pathogen Genomics and Microbial Evolution, Northwestern University Havey Institute for Global Health, Chicago, IL 60611, USA
| | - Egon A Ozer
- Department of Medicine, Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; Center for Pathogen Genomics and Microbial Evolution, Northwestern University Havey Institute for Global Health, Chicago, IL 60611, USA
| | - Judd F Hultquist
- Department of Medicine, Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; Center for Pathogen Genomics and Microbial Evolution, Northwestern University Havey Institute for Global Health, Chicago, IL 60611, USA.
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Hung KC, Li YY, Huang YT, Liu PH, Hsu CW, Ho CN, Hung IY, Chang FS, Sun CK. Efficacy of blood urea nitrogen-to-albumin ratio for predicting prognostic outcomes of inpatients with COVID-19: A meta-analysis. Medicine (Baltimore) 2023; 102:e33007. [PMID: 36800572 PMCID: PMC9936054 DOI: 10.1097/md.0000000000033007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND The associations between blood urea nitrogen (BUN)/albumin ratio and poor prognosis in patients with diagnosis of coronavirus disease 2019 (COVID-19) remain to be clarified. METHODS A search based on 4 electronic databases (i.e., EMBASE, Google scholar, MEDLINE, and Cochrane Library) was performed on June 23, 2022. The association of BUN/Albumin ratio with poor prognostic outcomes, defined as patients with mortality/severe illnesses, were analyzed. RESULTS Results from analysis of 7 cohort studies (3600 individuals with COVID-19) published between 2020 and 2022 showed a higher BUN/Albumin ratio in the poor-prognosis group (Mean difference: = 2.838, 95% confidence interval: 2.015-3.66, P < .001, I2 = 92.5%) than the good-prognosis group. Additional investigation into the connection between BUN/Albumin ratio as a binary variable (i.e., high or low) and the risk of poor outcome also supported an association between a higher BUN/Albumin ratio and a poor prognostic risk (odd ratio = 3.009, 95% confidence interval: 1.565-5.783, P = .001, I2 = 93.7%, 5 studies). Merged analysis of poor prognosis produced a sensitivity of 0.76, specificity of 0.72, and area under curve of 0.81. CONCLUSION This meta-analysis demonstrated a positive correlation between BUN/albumin ratio and poor outcome in patients with COVID-19. Additional large-scale prospective studies are needed to verify our findings.
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Affiliation(s)
- Kuo-Chuan Hung
- School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan
- Department of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan
| | - Yu-Yu Li
- Department of Anesthesiology, Chi Mei Medical Center, Chiali, Tainan City, Taiwan
| | - Yen-Ta Huang
- Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Ping-Hsin Liu
- Department of Anesthesiology, E-Da Dachang Hospital, I-Shou University, Kaohsiung City, Taiwan
| | - Chih-Wei Hsu
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, Taiwan
| | - Chun-Ning Ho
- Department of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan
| | - I-Yin Hung
- Department of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan
| | - Fu-Sheng Chang
- Department of Family Medicine, Show Chwan Memorial Hospital, Changhua City, Taiwan
| | - Cheuk-Kwan Sun
- Department of Emergency Medicine, E-Da Hospital, I-Shou University, Kaohsiung City, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung City, Taiwan
- * Correspondence: Cheuk-Kwan Sun, Department of Emergency Medicine, E-Da Hospital, Kaohsiung city, Taiwan, College of Medicine, I-Shou University, No.1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung City 82445, Taiwan (e-mail: )
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Shokr H, Marwah MK, Siddiqi H, Wandroo F, Sanchez-Aranguren L, Ahmad S, Wang K, Marwah S. Lactate Dehydrogenase/Albumin To-Urea Ratio: A Novel Prognostic Maker for Fatal Clinical Complications in Patients with COVID-19 Infection. J Clin Med 2022; 12:jcm12010019. [PMID: 36614820 PMCID: PMC9821448 DOI: 10.3390/jcm12010019] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/06/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
Objective: To investigate lactate dehydrogenase/Albumin to-urea (LAU) ratio as a potential predictor for COVID-19-induced fatal clinical complications in hospitalized patients. Methods: This is a retrospective study involving blood analyses from 1139 hospitalised COVID-19 infection survivors and 349 deceased cases post-COVID-19 infection. Laboratory tests included complete blood picture, inflammatory markers, and routine organ function tests. Results: The non-survivor group showed lower haemoglobin (p < 0.001), platelet (p < 0.0001) and higher mean corpuscular volume, neutrophil count, neutrophil/lymphocytes ratio (NLR), and LAU (p < 0.001, p < 0.0013, p < 0.001, p < 0.0126) than the patients who survived the infection. The non-survivors also exhibited higher markers for infection-related clinical complications, such as international normalized ratio (INR), D-dimer, urea, total bilirubin, alkaline phosphatase (ALK), creatinine, c-reactive protein (CRP), and serum ferritin levels (all p < 0.05). In addition, LAU ratio was positively correlated with infection prognostic parameters including INR (r = 0.171), D-dimer (r = 0.176), serum urea (r = 0.424), total bilirubin (r = 0.107), ALK (r = 0.115), creatinine (r = 0.365), CRP (r = 0.268), ferritin (r = 0.385) and negatively correlated with serum albumin (r = −0.114) (p ≤ 0.05). LAU ratio had an area under receiver operating characteristic of 0.67 compared to 0.60 with NLR. Conclusion: Patients with a high LAU ratio are at increased risk of mortality due to COVID-19 infection. Therefore, early assessment of this parameter, intensive intervention and close monitoring could improve their prognosis.
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Affiliation(s)
- Hala Shokr
- Pharmacy Division, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK
- Correspondence: (H.S.); (S.M.)
| | - Mandeep Kaur Marwah
- Aston Medical School, College of Health and Life Sciences, Aston University, Birmingham B4 7ET, UK
| | - Hisam Siddiqi
- Department of Haematology, Sandwell and West, Birmingham Hospitals NHS Trust, West Bromwich B71 4HJ, UK
| | - Farooq Wandroo
- Department of Haematology, Sandwell and West, Birmingham Hospitals NHS Trust, West Bromwich B71 4HJ, UK
| | | | - Shakil Ahmad
- Aston Medical School, College of Health and Life Sciences, Aston University, Birmingham B4 7ET, UK
| | - Keqing Wang
- Aston Medical School, College of Health and Life Sciences, Aston University, Birmingham B4 7ET, UK
| | - Sukhjinder Marwah
- Department of Haematology, Sandwell and West, Birmingham Hospitals NHS Trust, West Bromwich B71 4HJ, UK
- Correspondence: (H.S.); (S.M.)
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Rahimi FS, Afaghi S, Tarki FE, Omran HS, Nasirpour MH. Risk factors, thromboembolic events, and clinical course of New-Onset Atrial Fibrillation among COVID-19 hospitalized patients: A multicenter cross-sectional analysis in Iran. Health Sci Rep 2022; 5:e813. [PMID: 36268459 PMCID: PMC9577120 DOI: 10.1002/hsr2.813] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/29/2022] [Accepted: 08/16/2022] [Indexed: 11/17/2022] Open
Abstract
Background and Aims We focused on determining the risk factors, thromboembolic events, and clinical course of New-Onset Atrial Fibrillation (NOAF) among hospitalized coronavirus disease (COVID-19) patients. Methods This retrospective study was conducted in the major referral centers in Tehran, Iran. Of 1764 patients enrolled in the study from January 2020 until July 2021, 147 had NOAF, and 1617 had normal sinus rhythm. Univariate and multivariate Logistic regressions were employed accordingly to evaluate NOAF risk factors. The statistical assessments have been run utilizing SPSS 25.0 (SPSS) or R 3.6.3 software. Results For the NOAF patients, the age was significantly higher, and the more prevalent comorbidities were metabolic syndrome, heart failure (HF), peripheral vascular disease, coronary artery disease, and liver cirrhosis. The multivariate analysis showed the established independent risk factors were; Troponin-I (hazard ratio [HR] = 3.86; 95% confidence interval [CI] = 1.89-7.87; p < 0.001), HF (HR = 2.54; 95% CI = 1.61-4.02; p < 0.001), bilateral grand-glass opacification (HR = 2.26; 95% CI = 1.68-3.05; p = 0.002). For cases with thromboembolic events, NOAF was the most important prognostic factor (odds ratio [OR] = 2.97; 95% CI = 2.03-4.33; p < 0.001). While evaluating the diagnostic ability of prognostic factors in detecting NOAF, Troponin-I (Area under the curve [AUC] = 0.85), C-Reactive Protein (AUC = 0.72), and d-dimer (AUC = 0.65) had the most accurate sensitivity. Furthermore, the Kaplan-Meier curves demonstrated that the survival rates diminished more steeply for patients with NOAF history. Conclusion In hospitalized COVID-19 patients with NOAF, the risk of thromboembolic events, hospital stay, and fatality are significantly higher. The established risk factors showed that patients with older age, higher inflammation states, and more severe clinical conditions based on CHADS2VASC-score potentially need subsequent preventive strategies. Appropriate prophylactic anticoagulants, Initial management of cytokine storm, sufficient oxygen support, and reducing viral shedding could be of assistance in such patients.
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Affiliation(s)
- Fatemeh Sadat Rahimi
- Department of Surgery, Clinical Research and Development Center, Shahid Modarres HospitalShahid Beheshti University of Medical SciencesTehranIran
| | - Siamak Afaghi
- Research Institute of Internal Medicine, Shahid Modarres HospitalShahid Beheshti University of Medical SciencesTehranIran
| | - Farzad Esmaeili Tarki
- Research Institute of Internal Medicine, Shahid Modarres HospitalShahid Beheshti University of Medical SciencesTehranIran
| | - Hossein Salehi Omran
- Research Institute of Internal Medicine, Shahid Modarres HospitalShahid Beheshti University of Medical SciencesTehranIran
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Fibrinogen-to-Albumin Ratio and Blood Urea Nitrogen-to-Albumin Ratio in COVID-19 Patients: A Systematic Review and Meta-Analysis. Trop Med Infect Dis 2022; 7:tropicalmed7080150. [PMID: 36006242 PMCID: PMC9414552 DOI: 10.3390/tropicalmed7080150] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 07/13/2022] [Accepted: 07/15/2022] [Indexed: 01/08/2023] Open
Abstract
Fibrinogen-to-albumin ratio (FAR) and blood urea nitrogen-to-albumin ratio (BAR) are inflammatory biomarkers that have been associated with clinical outcomes of multiple diseases. The objective of this study is to evaluate the association of these biomarkers with the severity and mortality of COVID-19 patients. A systematic search was performed in five databases. Observational studies that reported the association between FAR and BAR values with the severity and mortality of COVID-19 patients were included. Random-effects models were used for meta-analyses, and effects were expressed as Odds Ratio (OR) and their 95% confidence intervals (CI). Publication bias was assessed using the Begg test, while the quality assessment was assessed using the Newcastle Ottawa Scale. A total of 21 studies (n = 7949) were included. High FAR values were associated with a higher risk of severity (OR: 2.41; 95% CI 1.41−4.12; p < 0.001) and mortality (OR: 2.05; 95% CI 1.66−2.54; p < 0.001). High BAR values were associated with higher risk of mortality (OR: 4.63; 95% CI 2.11−10.15; p < 0.001). However, no statistically significant association was found between BAR values and the risk of severity (OR: 1.16; 95% CI 0.83−1.63; p = 0.38). High FAR and BAR values were associated with poor clinical outcomes.
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