Urinalysis parameters as a useful tool to predict severity in coronavirus disease 2019 (COVID19)

Introduction: Since the onset of the new SARS-CoV-2 outbreak, several studies have focused on acute respiratory syndrome. However, little attention was paid to the acute kidney injury incidence in those patients. Objective: This study aims to evaluate the role of urinalysis for predicting severity in COVID19. Methods: Prospective study conducted in January 2021 in a tertiary teaching hospital in Tunis. Patients admitted either in pulmonology (G1) or in intensive care unit (G2) for COVID19 confirmed by RT-PCR were included. Clinical and radiological features as well as urine and blood tests (urea/creatinine) were assessed. Known patients with chronic renal failure were not included. Results: 47 patients (mean age: 58.3 ± 12.7 years, sex ratio: 1.93) were included (G1:n=28; G2:n=19). Proteinuria was found in 51% of cases, hematuria in 38% and urobilinogen in 8.5%.Median urine pH was 5.53 ±1.48 and median urine density was 1015±8.1. Renal dysfunction was found to be more frequent in G2 (38.9% vs 3,8%, p=0.003). Hematuria as well as proteinuria were significantly more frequent in G2 too (respectively 63.2% vs 21.4%; p=0.004 and 78.9% vs. 32.1; p=0.002). Remarkably, proteinuria and hematuria were positively correlated with renal impairement (p<0.001 and p=0.019 respectively), with important extent of lung abnormalities at CT scan (p=0.015 and p=0.002 respectively) and with lower pulsed oxygen saturation in the ambient air ( 83% vs. 91% and 82% vs. 90% respectively). Conclusion: Abnormal urine analysis and kidney dysfunction were high in COVID-19, especially in patients admitted to the ICU. Hence, urinalysis shall be regularly performed in all patients with COVID-19.