Discussion
COVID-19 disease spread throughout the World, starting in China in 2019
and It was accepted by the World Health Organization as a pandemic. It
is a RNA virus known as coronavirus 2 (SARS-CoV-2) which causes life
losses all over the World. Clinical findings are non-specific and
usually include cough, fever, myalgia, weakness, and nausea2,3. In patients with high comorbidity, it may be more
severe and cause multi-organ failure 3.
According to the latest Coronavirus Pneumonia Diagnosis and Treatment
Program (7th Edition), patients are divided into four groups as mild,
moderate, severe and critical. Clinical findings of patients, blood
values, respiratory count, and blood pressure are useful in determining
the severity of the disease 11.
In a study that compared the COVID-19 patients and controls, the
incidence of protein and erythrocyte in the urine of patients was higher
than the controls (p<0.05). Besides, urine pH and SG were
considerably different from the controls. However, the incidence of
leukocytes in urine did not differ between the patient and the healthy
group. This is because SARS-CoV-2 infection has been linked to
non-bacterial 10. In our study, the positive rates of
erythrocyturia (p<0.001), proteinuria (p=0.015), and
glucosuria (p=0.020) were higher in patients than controls. SG was
considerably lower in the patients than controls. Besides, urine pH
value of patients was significantly higher than controls. However, urine
pH and SG values were similar in the patient groups. The average age,
glucosuria, erythrocyturia, and proteinuria of severe and critical
patients were significantly higher compared to the moderate group.
COVID-19 disease is mostly asymptomatic, and symptomatic patients are
treated by hospitalization. In our study, two critical predictive
factors, advanced age and proteinuria, were found to be correlated with
the COVID-19 disease severity. For this reason, we think that these
patients should be hospitalized and closely follow-up even if they are
asymptomatic. The frequency of ARDS is observed more frequently in
severe patients than non-severe patients 12. The
cytokine storm thought to cause the ARDS table can cause multiple organ
failure, affecting the kidney. In the severe and critical group, we
believe that kidney damage caused by this mechanism causes proteinuria.
As a result, urine biochemical parameters have no place in the diagnosis
of COVID-19 disease but are valuable in terms of the disease’s
progression. Therefore, we think it would be useful to routinely examine
the biochemical parameters of urine that are easily applicable and
cost-effective in all COVID-19 patients.