Can a urine test act as an early warning system for a severe course of infection with COVID?

Acute kidney failure is one of the most dangerous consequences of a coronavirus infection. It’s no wonder that more and more patients are asking: What can I do to protect my kidneys? Above all, it is important to regularly monitor kidney function using means such as urine analysis. The Reactif urine tests from the medical-technology company nal von minden, which is based in Germany, determine up to 14 health and kidney-related parameters within a matter of seconds. The test serves doctors and home-users as a diagnostic aid for the monitoring of a range of health-related parameters.

“For people who are – or have been – infected with coronavirus, checking the kidneys regularly can really bring peace of mind,” says Roland Meißner, CEO at nal von minden GmbH. “A urine test is a good way of identifying potential changes in kidney function”, says Meißner. “A urine test provides patients with extra surety. It is an excellent method of monitoring. The earlier potential kidney damage is recognised, the better it can be treated.”

The Reactif urine test looks at a variety of parameters for the purpose of monitoring overall health, kidney function included. Tests for professional use can test up to 14 parameters, whereas those for private use test up to 11 parameters (see info box), one of which is protein. The presence of small amounts of protein in urine is normal and no cause for concern. However, large amounts can be an indicator of kidney damage. Another important parameter is white blood cells (leukocytes): Increased levels in urine can signify a kidney infection.

The Reactif urine test can be carried out by doctors in a GP practice or by individuals at home, as it is also designed for self-testing. The test procedure is quick and easy: Simply dip the test strip in urine, then remove it. Depending on the parameter, results will be available within 60 – 120 seconds. Place the test strip next to the reference colour chart and compare the colour panels.

“In the event of deviation from normal levels, the affected individual should contact their doctor for further diagnosis,” advises Meißner. The nal von minden CEO does not see the urine test as an alternative to a visit to your GP, but rather as a means of providing additional protection for patients who were – or are – infected with coronavirus. “Parameters tested by your GP can be checked over in order to shed light on any potential irregularities.”

Above all, Meißner hopes that monitoring kidney levels can help to prevent deterioration or even death. As several studies (see below) have already shown, COVID-19 affects not only the lungs but also the kidneys. Even in mild cases, it is common to see changes in the urine. In severe cases, the kidneys can fail completely and this can often be deadly. Meißner explains that “the urine test is an early warning system for severe COVID cases.”

The Reactif urine test is already available. It costs approximately 15 euros for 100 test strips. Professional users can buy the tests directly from nal von minden GmbH at www.nal-vonminden.com. Private users can find the tests at www.self-diagnostics.com

Kidney failure. The kidneys fulfil an important function in the body. They act as a point of detoxification, filtering out harmful substances from the body. They also produce the urine that is excreted through the bladder. The problem is that kidney disease is often identified too late. In the early stages there are hardly any symptoms. It is only in the later stages that patients experience, for example, nausea, tiredness and a dull ache in the kidney region. If the kidney tissue becomes diseased, the kidneys can only work to a limited extent. The final stage, kidney failure, is life-threatening. The kidneys no longer function and cannot excrete harmful substances, leaving the body in danger of being poisoned.

Reactif urine test for self-use, determines 11 parameters simultaneously.

The Reactif urine test was designed as a self-test for home use. The urine test strips allow you to check 11 different parameters simultaneously. Please note: In the event of any irregularities in your results, please consult your doctor for a more accurate diagnosis.

Proteins. A high level of proteins in urine can indicate inflammation of the kidneys. In patients belonging to risk groups (such as those with diabetes or hypertension), measuring protein levels in urine can support the early detection of the beginnings of kidney damage.

A high leukocyte (white blood cell) count in urine can indicate inflammation of the kidneys, genitals or urinary tract.

Blood (haemoglobin). No blood should be present in urine. Its presence can indicate, for example, a urinary tract infection or kidney/bladder stones.

Nitrite. In the absence of bacteria, nitrite is not found in urine. If it is present, this can indicate pyelonephritis (an infection of the kidneys).

Glucose (sugar). Urine usually contains so little glucose that it would not show up on a urine test strip. Raised urinary sugar levels can indicate diabetes or kidney disease.

Bilirubin is a natural metabolite, produced during the body's own breakdown of red blood cells in the spleen. Elevated levels can indicate a disease of the liver or gall bladder.

Urobilinogen. The detection of urobilinogen in urine aids a more precise diagnosis of liver and biliary tract diseases. Urobilinogen is formed during the breakdown of bilirubin in the gut.

Ketones. Ketones are metabolic products formed when fat is broken down, and are excreted in the urine. They are produced in larger quantities, for example, in those with diabetes or a high fever.

pH-level. Provides information on the acid-base-balance. pH levels rise when urine is too acidic, which can in turn indicate a urinary tract infection.

Specific gravity. This is the measure of urine density. A low urine specific gravity level can occur in those with kidney disease. A high reading is also an indicator of cardiac insufficiency and liver disease.

Ascorbic acid (Vitamin C). In high concentrations, ascorbic acid interferes with the detection of blood and glucose. It is therefore used as a control panel to ensure that other values are not falsified.

Studies:
Acute kidney injury: prevention, detection and management [NG148]. Available at https://www.nice.org.uk/guidance/ng148

Hirsch JS, Ng JH, et al. (2020). Acute kidney injury in patients hospitalized with COVID-19. Clinical Investigation, 98(1), 209-218.