Frontiers in Endocrinology (Jun 2021)

Association Between the Concentration and Rangeability of Cystatin C and Mortality of COVID-19 Patients With or Without Type 2 Diabetes Mellitus: A Retrospective Analysis

  • Lei Yang,
  • Dou Xu,
  • Yiqing Tan,
  • Bolin Li,
  • Dan Zhu,
  • Jingbo Wang,
  • Hui Sun,
  • Xinglong Liu,
  • Xiaopu Zheng,
  • Ling Zhu,
  • Zhongyu Li

DOI
https://doi.org/10.3389/fendo.2021.642452
Journal volume & issue
Vol. 12

Abstract

Read online

BackgroundWe investigated if the concentration and “rangeability” of cystatin C (CysC) influenced the prognosis of coronavirus disease 2019 (COVID-19) in patients suffering from, or not suffering from, type 2 diabetes mellitus (T2DM).MethodsA total of 675 T2DM patients and 572 non-T2DM patients were divided into “low” and “high” CysC groups and low and high CysC-rangeability groups according to serum CysC level and range of change of CysC level, respectively. Demographic characteristics, clinical data, and laboratory results of the four groups were analyzed.ResultsCOVID-19 patients with a high level and rangeability of CysC had more organ damage and a higher risk of death compared with those with a low level or low rangeability of CysC. Patients with a higher level and rangeability of CysC had more blood lymphocytes and higher levels of C-reactive protein, alanine aminotransferase, and aspartate aminotransferase. After adjustment for possible confounders, multivariate analysis revealed that CysC >0.93 mg/dL was significantly associated with the risk of heart failure (OR = 2.231, 95% CI: 1.125–5.312) and all-cause death (2.694, 1.161–6.252). CysC rangeability >0 was significantly associated with all-cause death (OR = 4.217, 95% CI: 1.953–9.106). These associations were stronger in patients suffering from T2DM than in those not suffering from T2DM.ConclusionsThe level and rangeability of CysC may influence the prognosis of COVID-19. Special care and appropriate intervention should be undertaken in COVID-19 patients with an increased CysC level during hospitalization and follow-up, especially for those with T2DM.

Keywords