Predictive value of SII, NLR,creatinine and CRP on COVID-19 patients with AKI

Objective To explore the predictive values of systemic immune inflammatory index (SII), neutrophil and lymphocyte count ratio (NLR), creatinine and C-reactive protein (CRP) on corona virus disease 2019 (COVID-19) patients with acute kidney injury (AKI). Methods Patients who were diagnosed with COVID-19 in the COVID-19 epidemic hospitals of Jiangsu Province from January 20, 2020 to March 1, 2020 were enrolled. According to the presence of renal injury, the patients were divided into two groups: an AKI group and a non-AKI group. Both groups were compared for general information, clinical characteristics and laboratory examination results. Multivariate logistic regression analysis was used to screen the risk factors of AKI in COVID-19 patients. A ROC curve was plotted to calculate AUC and evaluate prognostic values. Results A total of 303 patients were enrolled in the current study. According to univariate analysis, there were statistical differences between the two groups in age, severity, respiratory failure, ICU admission, hypertension, diabetes mellitus, dyspnea, leukocyte count, neutrophil count, SII, NLR, lactate dehydrogenase, total bilirubin, albumin, glucose, urea, creatinine, uric acid, calcium ion, chloride ion, D-dimer, and C-reactive protein (CRP) (P<0.05). Binary Logistic regression analysis showed that SII, NLR, creatinine and CRP were the independent risk factors for AKI in COVID-19 patients.The ROC curve showed that the AUC of SII, NLR, creatinine and CRP were 0.630 (95% CI: 0.517—0.744), 0.651 (95% CI: 0.528—0.773), 0.943 (95% CI: 0.913-0.973) and 0.721 (95% CI: 0.607—0.834), respectively. The optimal cut-off values were 277.44, 3.89, 87.70 μmol/L and 13.37 g/L, respectively. The sensitivity was 100.0%, 45.8%, 100.0% and 66.7%, and the specificity was 26.2%, 82.1%, 79.9% and 66.7%, respectively. Conclusions SII, NLR, creatinine and CRP are the independent risk factors for AKI in patients with COVID-19. They are of good value in predicting the renal function injury and evaluating the prognosis in patients with COVID-19.