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Original Research

Blood Urea Nitrogen to Serum Albumin Ratio (BAR) Predicts Critical Illness in Patients with Coronavirus Disease 2019 (COVID-19)

, , , , , ORCID Icon & show all
Pages 4711-4721 | Published online: 21 Aug 2021

Figures & data

Table 1 Comparisons of Clinical Characteristics Among COVID-19 Patients

Figure 1 Study population.

Figure 1 Study population.

Figure 2 (A) The BUN, albumin and BAR values within 24 hours after admission in COVID-19 patients with or without critical illness. (B) Comparisons of the rates of critical illness among quartiles of BAR in COVID-19 patients. P values were calculated by Chi Square analysis.

Abbreviations: BUN, blood urea nitrogen; BAR, blood urea nitrogen to serum albumin ratio; COVID-19, coronavirus disease 2019.
Figure 2 (A) The BUN, albumin and BAR values within 24 hours after admission in COVID-19 patients with or without critical illness. (B) Comparisons of the rates of critical illness among quartiles of BAR in COVID-19 patients. P values were calculated by Chi Square analysis.

Figure 3 (A) ROC curve of BAR, BUN, albumin and CURB-65 for prediction of critical illness in COVID-19 patients. The AUC were 0.821 (95% CI: 0.784, 0.858; P<0.01) for BAR, 0.783 (95% CI: 0.743, 0.823; P<0.01) for BUN, 0.712 (95% CI: 0.664, 0.760; P<0.01) for albumin, and 0.744((95% CI: 0.690, 0.798; P<0.01) for CURB-65, respectively. The optimal predictive cut-off value of BAR was 3.7887 mg/g (specificity: 0. 690; sensitivity: 0.786). (B) Subgroup analysis for OR of COVID-19 patients with BAR ≥ 3.7887 mg/g versus BAR < 3.7887 mg/g stratified by area, age, sex, history of drinking or smoking, and comorbidity. P values were calculated by multivariate Logistics regression analysis.

Abbreviations: ROC, receiver operating characteristic; BAR, blood urea nitrogen to serum albumin ratio; COVID-19, coronavirus disease 2019; AUC, area under the curve; OR, odds ratios; 95% CI, 95% confidence interval.
Figure 3 (A) ROC curve of BAR, BUN, albumin and CURB-65 for prediction of critical illness in COVID-19 patients. The AUC were 0.821 (95% CI: 0.784, 0.858; P<0.01) for BAR, 0.783 (95% CI: 0.743, 0.823; P<0.01) for BUN, 0.712 (95% CI: 0.664, 0.760; P<0.01) for albumin, and 0.744((95% CI: 0.690, 0.798; P<0.01) for CURB-65, respectively. The optimal predictive cut-off value of BAR was 3.7887 mg/g (specificity: 0. 690; sensitivity: 0.786). (B) Subgroup analysis for OR of COVID-19 patients with BAR ≥ 3.7887 mg/g versus BAR < 3.7887 mg/g stratified by area, age, sex, history of drinking or smoking, and comorbidity. P values were calculated by multivariate Logistics regression analysis.

Figure 4 Predictive nomogram for critical illness in COVID-19 patients. Age (years); Unconsciousness (1: yes, 0: no); Respiratory rate (breath/min); Lymphocyte (×109/L); Total bilirubin (μ mol/L); BAR (mg/g).

Abbreviations: COVID-19, coronavirus disease 2019; BAR, blood urea nitrogen to serum albumin ratio.
Figure 4 Predictive nomogram for critical illness in COVID-19 patients. Age (years); Unconsciousness (1: yes, 0: no); Respiratory rate (breath/min); Lymphocyte (×109/L); Total bilirubin (μ mol/L); BAR (mg/g).

Figure 5 (A) The calibration curve of nomogram. (B) The DCA of nomogram.

Abbreviation: DCA, decision curve analysis.
Figure 5 (A) The calibration curve of nomogram. (B) The DCA of nomogram.