{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T18:57:12Z","timestamp":1787684232808,"version":"build-2784847793"},"reference-count":35,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,5,6]],"date-time":"2022-05-06T00:00:00Z","timestamp":1651795200000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Considering the role of higher blood urea nitrogen and lower serum albumin (SA) levels in deceased coronavirus disease 2019\u00a0(COVID\u201019) patients, an increased blood urea nitrogen to SA (B\/A) ratio may help to determine those at higher risk of critical illness. This study aimed to evaluate the correlation of the B\/A ratio with severity and 30\u2010day mortality in COVID\u201019 patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 433 adult patients with COVID\u201019 were enrolled. The laboratory markers were measured on admission. Disease severity was categorized into mild disease, severe pneumonia, acute respiratory distress syndrome (ARDS), sepsis, and septic shock. The mortality was followed for 30 days after admission. <jats:italic>\u03c7<\/jats:italic><jats:sup>2<\/jats:sup> test, Fisher's exact test, and Mann\u2013Whitney <jats:italic>U<\/jats:italic> test were performed, as appropriate. Also, logistic regression and the\u00a0receiver operating characteristic\u00a0(ROC) curve for the B\/A ratio are included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010day mortality rate was 27.25%. The frequency of mild, severe pneumonia, ARDS, sepsis, and septic shock was 30.72%, 36.95%, 24.02%, 6.00%, and 2.31%, respectively. B\/A ratio and SA levels were statistically different between alive and deceased patients. The mean B\/A ratio was different among classified disease severities, except for mild disease. Logistic regression revealed the B\/A ratio as an independent risk factor for sepsis after adjusting for age and sex. ROC analysis showed B\/A ratio had an area under the curve\u00a0(AUC) of 0.733 for mortality at the cutpoint of 4.944. AUC for sepsis was 0.617 which was greater than other disease severities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The results showed that B\/A ratio and SA levels are associated with mortality of COVID\u201019 patients. A higher B\/A ratio is, additionally, associated with COVID\u201019 severity, except in mild cases and it can act as an independent risk factor in sepsis. However, a greater B\/A ratio is not a significant predictor of COVID\u201019 severity, but it can predict mortality. Therefore, we suggest this marker for clinical assessment of patients with severe COVID\u201019.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hsr2.606","type":"journal-article","created":{"date-parts":[[2022,5,6]],"date-time":"2022-05-06T18:11:35Z","timestamp":1651860695000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["The role of blood urea nitrogen to serum albumin ratio in the\u00a0prediction of severity and 30\u2010day mortality in patients with COVID\u201019"],"prefix":"10.1002","volume":"5","author":[{"given":"Toktam","family":"Alirezaei","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saeede","family":"Hooshmand","sequence":"additional","affiliation":[{"name":"Department of Cardiology, School of Medicine Shahid Beheshti University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8849-329X","authenticated-orcid":false,"given":"Rana","family":"Irilouzadian","sequence":"additional","affiliation":[{"name":"School of Medicine Shahid Beheshti University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Behzad","family":"Hajimoradi","sequence":"additional","affiliation":[{"name":"Men's Health and Reproductive Health Research Center Shahid Beheshti University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadra","family":"Montazeri","sequence":"additional","affiliation":[{"name":"School of Medicine Shahid Beheshti University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arash","family":"Shayegh","sequence":"additional","affiliation":[{"name":"School of Medicine Shahid Beheshti University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,5,6]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12098-020-03263-6"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2020.104371"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(20)30074-7"},{"key":"e_1_2_12_5_1","unstructured":"WHO Organization.Coronavirus disease 2019 (COVID\u201019): situation report 70;2020."},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1620\/tjem.255.127"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2020.03.020"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.7326\/M20-0504"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2020.02.034"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.5812\/iranjradiol.106339"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(10)70194-8"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.15252\/msb.20209610"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.00217.2020"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.368.6489.356"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2008.12.015"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11427-020-1643-8"},{"key":"e_1_2_12_17_1","first-page":"28","article-title":"Hypoalbuminemia: an underestimated, vital characteristic of hospitalized COVID\u201019 positive patients?","volume":"6","author":"Ramadori G","year":"2020","journal-title":"Hepatoma Res"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-12-0040"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.5152\/balkanmedj.2012.089"},{"issue":"1","key":"e_1_2_12_20_1","first-page":"38","article-title":"Kidney function indicators predict adverse outcomes of COVID\u201019","volume":"2","author":"Liu Y\u2010M","year":"2021","journal-title":"Med (N Y)"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2021.03.090"},{"key":"e_1_2_12_22_1","doi-asserted-by":"crossref","unstructured":"World Health Organization.\u00a0Clinical management of severe acute respiratory infection (SARI) When COVID\u201019 disease is suspected: interim guidance 13 March 2020 2020.","DOI":"10.15557\/PiMR.2020.0003"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2010419"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30211-7"},{"issue":"1","key":"e_1_2_12_25_1","article-title":"Baseline characteristics and associated factors of mortality in COVID\u201019 patients; 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