Background Novel coronavirus disease 2019 (COVID-19), an acute respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), rapidly progressed to a global pandemic. Currently, there are limited effective medications approved for this deadly disease. Objective To investigate the potential predictors of COVID-19 mortality and risk factors for hyperinflammation in COVID-19. Methods Retrospective analysis was carried out in 1,149 patients diagnosed with COVID-19 in Tongji Hospital, Wuhan, China, from 1/13/2020 to 3/15/2020. Results We found significant differences in the rates of hyperuricemia (OR: 3.17, 95% CI: 2.13-4.70; p < 0.001) and hypoalbuminemia (OR: 5.68, 95% CI: 3.97-8.32; p < 0.001) between deceased and recovered patients. The percentages of hyperuricemia in deceased patients and recovered patients were 23.6% and 8.9%, respectively, which were higher than the reported age-standardized prevalence of 6.2% in Chinese population. Of note, the percentages of both IL-6 and uric acid levels in survived COVID-19 patients were above 90%, suggesting that they might be good specificity for indicators of mortality in COVID-19 patients. The serum level of uric acid (UA) was positively associated with ferritin, TNF- α , and IL-6 but not with anti-inflammatory cytokine IL-10. In addition, the levels of these proinflammatory cytokines in COVID-19 patients showed a trend of reduction after uric acid lowering therapy. Conclusions Our results suggest that uric acid, the end product of purine metabolism, was increased in deceased patients with COVID-19. In addition, the serum level of uric acid was positively associated with inflammatory markers. Uric acid lowering therapy in COVID-19 patients with hyperuricemia may be beneficial.
【초록키워드】 COVID-19, coronavirus disease, SARS-CoV-2, Coronavirus disease 2019, coronavirus, therapy, Risk factors, Cytokines, Mortality, IL-6, inflammatory markers, ferritin, cytokine, risk factor, severe acute respiratory syndrome Coronavirus, metabolism, Novel coronavirus, global pandemic, Prevalence, specificity, hyperinflammation, Respiratory disease, Wuhan, Patient, Retrospective analysis, predictor, recovered patients, IL-10, novel, respiratory, proinflammatory cytokines, medication, disease, COVID-19 patients, Analysis, COVID-19 mortality, Deceased, COVID-19 patient, acute respiratory disease, Hypoalbuminemia, uric acid, end product, reduction, Hyperuricemia, Proinflammatory cytokine, acute respiratory syndrome, significant difference, 95% CI, acute respiratory syndrome coronavirus, significant differences, acute respiratory syndrome coronavirus 2, Serum level, percentages, Chinese, Tongji Hospital, purine, TNF- α, anti-inflammatory cytokine, objective, effective, Wuhan, China, recovered patient, Result, caused, carried, reported, addition, approved, survived, diagnosed with COVID-19, patients with COVID-19, percentage, progressed, was increased, 【제목키워드】 COVID-19,