Organ Function Tests and Their Predictive Value in the Novel Coronavirus Disease 2019 Infection: A Retrospective Report from India

Novel coronavirus disease 2019 (COVID-19) has become a global public health calamity since its outbreak in Wuhan, China in December 2019, and there is a lack of diagnostic biochemical data related to the disease. This study aimed to investigate routine biochemical parameters in COVID-19 positive Indian patients and check their predictive value for the detection of this novel disease.

This observational study was conducted retrospectively with the participation of 166 patients referred to King Edward Memorial (KEM) Hospital, Mumbai, India during May 2020. The baseline characteristics (age and gender) and biochemical data of individuals with COVID-19-related symptoms but negative for COVID-19 were collected and classified into two groups of real-time reverse transcriptase polymerase chain reaction (RT-PCR) and COVID-19 positive. The value of organ function tests (blood urea nitrogen [BUN], creatinine, and levels of serum electrolytes, alanine aminotransferase [ALT], aspartate aminotransferase (AST), bilirubin total, bilirubin direct, total protein, and albumin) were noted and analyzed. The groups were compared using unpaired t test, and predictive value of these parameters for COVID-19 was evaluated by calculating the area under the ROC curve (AUC).

There was a significant rise in the serum AST ALT, bilirubin direct, BUN, and creatinine levels of COVID-19 subjects compared to non-COVID-19 ones (P<0.001). AST (AUC=0.826, CI: 0.76 to 0.89, P<0.001), ALT (AUC=0.8525, 95% CI: 0.79 to 0.90, P<0.001), and BUN (AUC=0.8097, 95% CI: 0.74 to 0.87, P<0.001) showed very good accuracy and serum creatinine (AUC=0.7971, 95% CI: 0.73 to 0.86, P<0.001) showed good accuracy in predicting COVID- 19 positivity.

Serum levels of ALT, AST, BUN, and creatinine can be the reliable predictors of COVID-19 test and identify infected patients.