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Leptospirosis is a neglected disease that continues to incur significant morbidity and mortality rates, despite advancements in identification and management. Early detection of severity factors in these patients is essential for guiding appropriate care. The primary objectives of this study were to assess the correlations between a mortality score (QuickLepto) in leptospirosis patients and early, non-traditional kidney biomarkers.
This is a prospective study that evaluated consecutive cases of leptospirosis admitted to the 3 tertiary hospitals in Fortaleza from January 2017 to April 2023. Utilizing the parameters and characteristics documented upon hospital admission, QuickLepto scores were computed for each patient and subsequently visualized in the context of mortality distribution. Blood and urine samples were obtained upon hospital admission for the quantification of severity and renal biomarkers (MCP-1, serum and urinary NGAL and FGF-23). Other clinical data of medical records were collected.
Among the 44 included patients, 81.8% were male, with an average age of 40.8 ± 16.9 years, and a 9.1% mortality rate. The correlations between the new QuickLepto score and the severity biomarkers measured on hospital admission have shown that serum NGAL showed a positive correlation with statistical significance (r=0.388, p=0.009). No association was observed with creatinine, serum FGF-23 and urinary MCP-1.
This indicates the potential utility of serum NGAL as a valuable marker in relation to the QuickLepto score's predictive capabilities. Conversely, no discernible associations were observed with creatinine, serum FGF-23, and urinary MCP-1, suggesting these parameters might not serve as direct indicators in the context of the QuickLepto score for the patient cohort examined.