Relationship between creatinine–cystatin C ratio and all-cause mortality in hospitalized patients with COVID-19: A prospective study in China
This study was conducted to investigate whether baseline creatinine–cystatin C ratio is associated with all-cause mortality in adult Chinese patients hospitalized with coronavirus disease 2019. This study included 933 patients with coronavirus disease 2019 who were admitted to The Affiliated Hospita...
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| Published in | Heliyon Vol. 10; no. 15; p. e35587 |
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| Main Authors | , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
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Elsevier Ltd
15.08.2024
Elsevier |
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| Abstract | This study was conducted to investigate whether baseline creatinine–cystatin C ratio is associated with all-cause mortality in adult Chinese patients hospitalized with coronavirus disease 2019.
This study included 933 patients with coronavirus disease 2019 who were admitted to The Affiliated Hospital of Guangdong Medical University between December 2022 and March 2023. All-cause mortality was determined by telephone follow-up after 28 days. Multivariate Cox proportional risk models were used to investigate the relationship between baseline creatinine–cystatin C ratio and all-cause mortality. Restricted cubic spline and two-piecewise Cox proportional hazards risk models were used to identify non-linear correlations.
Of the 933 patients, 128 died during the 28 days follow-up. The restricted cubic spline analysis of hospitalized patients with coronavirus disease 2019 revealed an L-shaped association between baseline creatinine–cystatin C ratio and all-cause mortality, with a threshold creatinine–cystatin C ratio of ≤0.93 predicting all-cause mortality. Specifically, a baseline creatinine–cystatin C ratio below this threshold value was negatively correlated with mortality (hazard ratio 0.12, 95 % confidence interval 0.03–0.48), but a creatinine–cystatin C ratio >0.93 was not correlated with mortality (hazard ratio 1.29, 95 % confidence interval 0.65–2.55).
In Chinese adult patients hospitalized with coronavirus disease 2019, an L-shaped relationship was observed between the baseline creatinine–cystatin C ratio and all-cause mortality. |
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| AbstractList | This study was conducted to investigate whether baseline creatinine-cystatin C ratio is associated with all-cause mortality in adult Chinese patients hospitalized with coronavirus disease 2019.BackgroundThis study was conducted to investigate whether baseline creatinine-cystatin C ratio is associated with all-cause mortality in adult Chinese patients hospitalized with coronavirus disease 2019.This study included 933 patients with coronavirus disease 2019 who were admitted to The Affiliated Hospital of Guangdong Medical University between December 2022 and March 2023. All-cause mortality was determined by telephone follow-up after 28 days. Multivariate Cox proportional risk models were used to investigate the relationship between baseline creatinine-cystatin C ratio and all-cause mortality. Restricted cubic spline and two-piecewise Cox proportional hazards risk models were used to identify non-linear correlations.MethodsThis study included 933 patients with coronavirus disease 2019 who were admitted to The Affiliated Hospital of Guangdong Medical University between December 2022 and March 2023. All-cause mortality was determined by telephone follow-up after 28 days. Multivariate Cox proportional risk models were used to investigate the relationship between baseline creatinine-cystatin C ratio and all-cause mortality. Restricted cubic spline and two-piecewise Cox proportional hazards risk models were used to identify non-linear correlations.Of the 933 patients, 128 died during the 28 days follow-up. The restricted cubic spline analysis of hospitalized patients with coronavirus disease 2019 revealed an L-shaped association between baseline creatinine-cystatin C ratio and all-cause mortality, with a threshold creatinine-cystatin C ratio of ≤0.93 predicting all-cause mortality. Specifically, a baseline creatinine-cystatin C ratio below this threshold value was negatively correlated with mortality (hazard ratio 0.12, 95 % confidence interval 0.03-0.48), but a creatinine-cystatin C ratio >0.93 was not correlated with mortality (hazard ratio 1.29, 95 % confidence interval 0.65-2.55).ResultsOf the 933 patients, 128 died during the 28 days follow-up. The restricted cubic spline analysis of hospitalized patients with coronavirus disease 2019 revealed an L-shaped association between baseline creatinine-cystatin C ratio and all-cause mortality, with a threshold creatinine-cystatin C ratio of ≤0.93 predicting all-cause mortality. Specifically, a baseline creatinine-cystatin C ratio below this threshold value was negatively correlated with mortality (hazard ratio 0.12, 95 % confidence interval 0.03-0.48), but a creatinine-cystatin C ratio >0.93 was not correlated with mortality (hazard ratio 1.29, 95 % confidence interval 0.65-2.55).In Chinese adult patients hospitalized with coronavirus disease 2019, an L-shaped relationship was observed between the baseline creatinine-cystatin C ratio and all-cause mortality.ConclusionsIn Chinese adult patients hospitalized with coronavirus disease 2019, an L-shaped relationship was observed between the baseline creatinine-cystatin C ratio and all-cause mortality. Background: This study was conducted to investigate whether baseline creatinine–cystatin C ratio is associated with all-cause mortality in adult Chinese patients hospitalized with coronavirus disease 2019. Methods: This study included 933 patients with coronavirus disease 2019 who were admitted to The Affiliated Hospital of Guangdong Medical University between December 2022 and March 2023. All-cause mortality was determined by telephone follow-up after 28 days. Multivariate Cox proportional risk models were used to investigate the relationship between baseline creatinine–cystatin C ratio and all-cause mortality. Restricted cubic spline and two-piecewise Cox proportional hazards risk models were used to identify non-linear correlations. Results: Of the 933 patients, 128 died during the 28 days follow-up. The restricted cubic spline analysis of hospitalized patients with coronavirus disease 2019 revealed an L-shaped association between baseline creatinine–cystatin C ratio and all-cause mortality, with a threshold creatinine–cystatin C ratio of ≤0.93 predicting all-cause mortality. Specifically, a baseline creatinine–cystatin C ratio below this threshold value was negatively correlated with mortality (hazard ratio 0.12, 95 % confidence interval 0.03–0.48), but a creatinine–cystatin C ratio >0.93 was not correlated with mortality (hazard ratio 1.29, 95 % confidence interval 0.65–2.55). Conclusions: In Chinese adult patients hospitalized with coronavirus disease 2019, an L-shaped relationship was observed between the baseline creatinine–cystatin C ratio and all-cause mortality. This study was conducted to investigate whether baseline creatinine-cystatin C ratio is associated with all-cause mortality in adult Chinese patients hospitalized with coronavirus disease 2019. This study included 933 patients with coronavirus disease 2019 who were admitted to The Affiliated Hospital of Guangdong Medical University between December 2022 and March 2023. All-cause mortality was determined by telephone follow-up after 28 days. Multivariate Cox proportional risk models were used to investigate the relationship between baseline creatinine-cystatin C ratio and all-cause mortality. Restricted cubic spline and two-piecewise Cox proportional hazards risk models were used to identify non-linear correlations. Of the 933 patients, 128 died during the 28 days follow-up. The restricted cubic spline analysis of hospitalized patients with coronavirus disease 2019 revealed an L-shaped association between baseline creatinine-cystatin C ratio and all-cause mortality, with a threshold creatinine-cystatin C ratio of ≤0.93 predicting all-cause mortality. Specifically, a baseline creatinine-cystatin C ratio below this threshold value was negatively correlated with mortality (hazard ratio 0.12, 95 % confidence interval 0.03-0.48), but a creatinine-cystatin C ratio >0.93 was not correlated with mortality (hazard ratio 1.29, 95 % confidence interval 0.65-2.55). In Chinese adult patients hospitalized with coronavirus disease 2019, an L-shaped relationship was observed between the baseline creatinine-cystatin C ratio and all-cause mortality. This study was conducted to investigate whether baseline creatinine–cystatin C ratio is associated with all-cause mortality in adult Chinese patients hospitalized with coronavirus disease 2019. This study included 933 patients with coronavirus disease 2019 who were admitted to The Affiliated Hospital of Guangdong Medical University between December 2022 and March 2023. All-cause mortality was determined by telephone follow-up after 28 days. Multivariate Cox proportional risk models were used to investigate the relationship between baseline creatinine–cystatin C ratio and all-cause mortality. Restricted cubic spline and two-piecewise Cox proportional hazards risk models were used to identify non-linear correlations. Of the 933 patients, 128 died during the 28 days follow-up. The restricted cubic spline analysis of hospitalized patients with coronavirus disease 2019 revealed an L-shaped association between baseline creatinine–cystatin C ratio and all-cause mortality, with a threshold creatinine–cystatin C ratio of ≤0.93 predicting all-cause mortality. Specifically, a baseline creatinine–cystatin C ratio below this threshold value was negatively correlated with mortality (hazard ratio 0.12, 95 % confidence interval 0.03–0.48), but a creatinine–cystatin C ratio >0.93 was not correlated with mortality (hazard ratio 1.29, 95 % confidence interval 0.65–2.55). In Chinese adult patients hospitalized with coronavirus disease 2019, an L-shaped relationship was observed between the baseline creatinine–cystatin C ratio and all-cause mortality. |
| ArticleNumber | e35587 |
| Author | Cao, Jiahao Chen, Xiaoer Zhao, Xuanna Wu, Dong Lin, Yiyan Wang, Duolao Wu, Bin Zhang, Yuanli Liu, Gege Long, Bingyu Fu, Xiaofang Huang, Bangxiao Huang, Dan |
| Author_xml | – sequence: 1 givenname: Dong surname: Wu fullname: Wu, Dong organization: Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524013, China – sequence: 2 givenname: Jiahao surname: Cao fullname: Cao, Jiahao organization: Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524013, China – sequence: 3 givenname: Yiyan surname: Lin fullname: Lin, Yiyan organization: Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524013, China – sequence: 4 givenname: Xiaoer surname: Chen fullname: Chen, Xiaoer organization: Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524013, China – sequence: 5 givenname: Bingyu surname: Long fullname: Long, Bingyu organization: Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524013, China – sequence: 6 givenname: Bangxiao surname: Huang fullname: Huang, Bangxiao organization: Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524013, China – sequence: 7 givenname: Gege orcidid: 0000-0002-0214-0301 surname: Liu fullname: Liu, Gege organization: Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524013, China – sequence: 8 givenname: Xiaofang surname: Fu fullname: Fu, Xiaofang organization: Clinical Laboratory Medicine Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524013, China – sequence: 9 givenname: Bin surname: Wu fullname: Wu, Bin organization: Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524013, China – sequence: 10 givenname: Dan surname: Huang fullname: Huang, Dan organization: Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524013, China – sequence: 11 givenname: Yuanli surname: Zhang fullname: Zhang, Yuanli organization: Department of Critical Care Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524013, China – sequence: 12 givenname: Duolao surname: Wang fullname: Wang, Duolao organization: Guangdong Key Laboratory of Age-Related Cardiac and Cerebral Diseases, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524013, China – sequence: 13 givenname: Xuanna surname: Zhao fullname: Zhao, Xuanna email: 792665234@qq.com organization: Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524013, China |
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| Keywords | Creatinine COVID-19 Sarcopenia Mortality Cystatin C |
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| Snippet | This study was conducted to investigate whether baseline creatinine–cystatin C ratio is associated with all-cause mortality in adult Chinese patients... This study was conducted to investigate whether baseline creatinine-cystatin C ratio is associated with all-cause mortality in adult Chinese patients... Background: This study was conducted to investigate whether baseline creatinine–cystatin C ratio is associated with all-cause mortality in adult Chinese... |
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| SubjectTerms | adults China confidence interval COVID-19 COVID-19 infection Creatinine Cystatin C hazard ratio hospitals Mortality prospective studies risk Sarcopenia telephones |
| Title | Relationship between creatinine–cystatin C ratio and all-cause mortality in hospitalized patients with COVID-19: A prospective study in China |
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