Association of SARS‑CoV‑2 Viral Load with Biochemical Profile of COVID-19 Patients: A Nigerian Experience

Abstract

Background: Kidney involvement in coronavirus disease 2019 (COVID-19) pathology has been supported by high frequency of angiotensin-converting enzyme 2 (ACE2) expression on renal cells and reports of acute kidney injury. However, the association between host viral load and kidney function is not  clear.

Aim: In this study, plasma levels of renal markers (urea nitrogen, creatinine, and estimated glomerular filtration rate (eGFR)) and electrolytes (sodium,  potassium, chlorine, and bicarbonate) were assessed in relation to SARS-CoV-2 viral load of COVID-19 patients.

Patients and Methods: This cross- sectional study involved 144 consenting COVID-19 patients admitted to the Ogun state COVID-19 isolation center between May and December 2020. All  participants presented with mild respiratory symptoms and did not require ICU admission or ventilation support. Data included reverse transcriptase  polymerase chain reaction (RT-PCR) cycle threshold (CT ) value, blood urea nitrogen (BUN), creatinine, sodium, potassium, chlorine, bicarbonate  measurements, and glomerular filtration rate. Reference intervals were used as comparators, and multiple linear regression model was fitted. Statistical  significance was set at P < 0.05.

Results: BUN level and creatinine were elevated in 4 (2.8%) and 42 (29.2%) patients, respectively, with lowered eGFR observed in 37 (25.7%) patients. Hyponatremia and hypokalemia were observed in 35 (24.3%) and 21 (14.6%) patients, respectively, while hypochloremia  was observed in 21 (14.6%) patients. Lowered bicarbonate was observed in 29 (20.1%) patients. Linear regression showed statistically significant  association (R² = 0.340, P = 0.032) between RT-PCR CT value and eGFR (β = 0.006, P = 0.017) as well as HCO₃ (β = -0.262, P = 0.036).

Conclusion: COVID-19  patients with mild respiratory symptoms exhibited renal abnormalities, electrolytes, and acid-base imbalances which were partly associated with SARS- CoV-2 viral load.