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    Are High Urea Values before Intravenous Immunoglobulin Replacement a Risk Factor for COVID-19 Related Mortality?
    (2022) Aytekin, Gökhan; Atayik, Emel
    Aim: This study aimed to examine the data of the coronavirus disease 2019 (COVID-19) patients treated with intravenous immunoglobulin (IVIG) treatment and to investigate the effects of the patients' clinical, laboratory, and treatment characteristics and risk factors for mortality. Material and Methods: The study evaluated 81 adult COVID-19 patients who were hospitalized for the treatment of COVID-19 between April 2020 and September 2020 and were followed up, treated, and consulted in the immunology clinic for IVIG treatment, in a retrospective manner. Results: The univariate analyses revealed that the duration of hospitalization in service, being intubated, duration of IVIG treatment, and the urea value before IVIG treatment were related to mortality in COVID-19 patients treated with IVIG treatment. As a result of multivariate analysis, being intubated and urea value before IVIG treatment were found to be independent risk factors for mortality (p=0.001 and p=0.009, respectively). It was found that for the 60 mg/dL level of urea value before IVIG treatment to predict mortality, the sensitivity was 46.2%, and the specificity was 35.5%. The area under the curve was found as 0.647; 95% confidence interval 0.518-0.776 (p=0.029). Conclusion: The study found that urea values before IVIG treatment were a risk factor for mortality in patients who received IVIG treatment for COVID-19. This is important as it indicates that urea values should be closely monitored in patients given IVIG treatment for COVID-19. It also suggests that when resources are limited and risk stratification is required in COVID-19 patients, urea values can be helpful.