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.