Cystatin C and Neutrophil Gelatin-associated Lipocalin (NGAL) Can Predict Acute Kidney Injury and In-Hospital Mortality in COVID-۱۹ Patients

Background: Prediction and early diagnosis of acute kidney injury (AKI) in critically ill Coronavirus disease ۲۰۱۹ (COVID-۱۹) patients are of great importance. Therefore, using promising renal biomarkers such as cystatin C and neutrophil gelatinase-associated lipocalin (NGAL) to identify the risk of future AKI is crucial. Materials and Methods: A total of ۸۹ adult patients with COVID-۱۹ were included in this study. Serum cystatin C and NGAL concentration were assessed on intensive care unit (ICU) admission then repeated after ۴۸ hours. Serum creatinine was followed for ۷ days to report the development of AKI. Results: Among the COVID-۱۹ patients, ۲۸.۱% developed AKI. Although admission serum creatinine was not significantly different between the AKI group and the non-AKI group (p=۰.۳۷۵), admission Cystatin C (p=۰.۰۱۸), and NGAL (p<۰.۰۰۱) were significantly different between both groups. After ۴۸ hours, a change in Cystatin C level (p<۰.۰۰۱) but not NGAL (p=۰.۴) was a predictor for AKI. Logistic regression model including age (p=۰.۰۳۱), Cystatin C on ۴۸ hrs (p=۰.۰۰۳) and NGAL on admission (p=۰.۰۱۵) could predict AKI in COVID-۱۹ patients. Conclusion: Serum Cystatin C and NGAL in ICU could be used to predict AKI in COVID-۱۹ patients. A logistic regression model including age, Cystatin C on ۴۸hrs, and NGAL on admission might be a tool for individualized risk estimation of AKI in COVID-۱۹ patients.

Keywords:

Cystatin C , NGAL , Acute kidney injury , COVID-۱۹ , In-Hospital mortality