Higher albumin levels on admission predict better prognosis in patients with confirmed COVID-19

Kheir, Matthew; Saleem, Farah; Wang, Christy; Mann, Adin; Chua, Jimmy

doi:10.1371/journal.pone.0248358

Cited by 65 publications

(75 citation statements)

References 43 publications

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“…Kheir et al study showed higher albumin levels on admission were associated with significantly fewer adverse outcomes in COVID-19 patients. 7 A metanalysis done by Panagiotis et al demonstrated the presence of significantly lower serum albumin concentrations in COVID-19 patients with high disease severity or poor outcome which is supporting the results of our study. 8 Regarding the association with comorbidities, our study found that serum albumin levels was significantly lower in severe COVID-19 patients with diabetes and hypertension.…”

Section: Discussionsupporting

confidence: 92%

Study of serum albumin as a marker of severity in COVID-19 positive SARI and COVID-19 negative SARI patients

et al. 2021

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Background: COVID-19 a pandemic caused by SARS CoV-2 has caused a wide impact globally. Clinical spectrum of COVID-19 ranges widely including asymptomatic infection, mild upper respiratory tract infection, severe pneumonia, ARDS, MODS and even death. Hypoalbuminemia in COVID-19 indicates severe disease. The aim of the study was to determine incidence of hypoalbuminemia and correlation of severity of hypoalbuminemia with COVID-19 positive SARI and COVID negative SARI patients.Methods: A study was conducted on 265 SARI patients who were admitted in hospitals attached to BMCRI. History was taken, general physical examination and a detailed systemic examination was done. Patients were categorized into mild, moderate and severe illness. RT-PCR for COVID-19 patients done using throat and nasal swab. Total WBC counts and differential counts, platelet counts were estimated. Serum albumin levels were correlated with pneumonia severity and compared between COVID-19 positive and Negative SARI. And also, correlation with comorbities was done.Results: The study included 265 SARI patients, of which 135 were COVID-19 positive patients and 130 were COVID-19 negative. Patients categorized into moderate and severe SARI. Mean age of subjects with COVID-19 positive (severe) was higher- 58.70±15.598 followed by COVID-19 positive (moderate)- 55.13±14.480. About 30% (N=90) were belong to severe SARI group, Chi-square test showed statistical significant association with respect to age. Chi-square test showed no statistical significant association with respect to gender. Independent sample t test showed statistical difference with respect to S. albumin levels between COVID positive and COVID negative subjects. In COVID positive subjects, S. albumin levels showed statistical significant difference between moderate and severe sub groups whereas there was no statistical significant difference seen in COVID negative sub groups.Conclusions: The relationship between hypoalbuminemia and reduced survival in COVID-19 may have several explanations. First, acting as an anti-inflammatory and antioxidant protein, albumin may protect against cytokine storm. Second, albumin encompasses anticoagulant properties and inhibits oxidative stress-related clotting and platelet activation that occurs in severe COVID-19. Third, albumin is an inverse acute phase reactant. In our present study hypoalbuminemia was more significant in severe COVID-19 positive SARI patients compared to COVID-19 negative SARI patients hence, we could say that hypoalbuminemia is inversely related with COVID-19 severity and also more significant hypoalbuminemia in COVID-19 positive SARI.

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Section: Discussionsupporting

confidence: 92%

Study of serum albumin as a marker of severity in COVID-19 positive SARI and COVID-19 negative SARI patients

et al. 2021

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“…The low albumin has been associated with adverse outcomes in various other disease conditions [18][19][20][21][22][23], as well as in COVID-19 patients who were hospitalized [9,10,24]. Kheir et al concluded in their study that higher albumin level on admission was associated with favorable outcomes in hospitalized COVID-19 patients [11]. We hope this study will help understand the characteristics of COVID-19 who did not require hospitalization.…”

Section: Plos Onementioning

confidence: 87%

“…It binds with the reactive oxygen species (ROS) and reactive nitrogen species (RNS) produced during inflammation saving cellular injury [8]. Few studies found that low serum has a direct effect on mortality and worse complications in hospitalized COVID-19 patients [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Low serum albumin and the risk of hospitalization in COVID-19 infection: A retrospective case-control study

et al. 2021

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Background The data on the COVID-19 patients who were discharged to self-quarantine is lacking. Aim The aim of the study was to investigate the percentage of COVID-19 positive patients that were hospitalized within a three-week period after discharge from ED to self-quarantine. Methods The patients who had confirmed SARS-CoV-2 on RT-PCR of the nasopharyngeal swab and were discharged from ED of a tertiary care hospital in the USA to self-quarantine from March 01- July 31, 2020, were included. Patients were divided into two groups based on serum albumin levels and were followed up for three weeks to see if low level of albumin increased the risk of hospitalization. Univariate and multivariate logistic regression analyses were performed to study the effect of albumin level and outcomes. Results A total of 112 patients were included in the study out of which 65 had low serum albumin (<3.5 g/dL) and 47 had normal serum albumin (≥3.5 g/dL). More than 10% of patients discharged to self-quarantine needed hospitalization within three weeks. The Low albumin group had more co-morbidities at baseline. The low serum albumin group had 10 (15.38%) vs 2 (4.26%), p = 0.06 hospitalizations as compared to the normal serum albumin group. The multivariate logistic regression analysis did not reveal lower odds of hospitalization in the group with normal albumin, (OR 0.26, 95% CI 0.03–1.92, p = 0.19) after controlling for age, sex, and various co-morbidities. Conclusion The low serum albumin was not associated with the risk of hospitalization in COVID-19 patients who were initially discharged to self-quarantine.

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“…Serum hypoalbuminemia at admission has been associated with a worse prognosis including the risk of hospital readmission 22 . Yeo et al, observed a direct correlation between the peak creatinine concentration during admission and the risk of readmission 10 .…”

Section: Discussionmentioning

confidence: 99%

Frequency, risk factors, and outcomes of hospital readmissions of COVID-19 patients

Ramos‐Martínez

Parra-Ramirez

Morrás

et al. 2021

Sci Rep

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To determine the proportion of patients with COVID-19 who were readmitted to the hospital and the most common causes and the factors associated with readmission. Multicenter nationwide cohort study in Spain. Patients included in the study were admitted to 147 hospitals from March 1 to April 30, 2020. Readmission was defined as a new hospital admission during the 30 days after discharge. Emergency department visits after discharge were not considered readmission. During the study period 8392 patients were admitted to hospitals participating in the SEMI-COVID-19 network. 298 patients (4.2%) out of 7137 patients were readmitted after being discharged. 1541 (17.7%) died during the index admission and 35 died during hospital readmission (11.7%, p = 0.007). The median time from discharge to readmission was 7 days (IQR 3–15 days). The most frequent causes of hospital readmission were worsening of previous pneumonia (54%), bacterial infection (13%), venous thromboembolism (5%), and heart failure (5%). Age [odds ratio (OR): 1.02; 95% confident interval (95% CI): 1.01–1.03], age-adjusted Charlson comorbidity index score (OR: 1.13; 95% CI: 1.06–1.21), chronic obstructive pulmonary disease (OR: 1.84; 95% CI: 1.26–2.69), asthma (OR: 1.52; 95% CI: 1.04–2.22), hemoglobin level at admission (OR: 0.92; 95% CI: 0.86–0.99), ground-glass opacification at admission (OR: 0.86; 95% CI:0.76–0.98) and glucocorticoid treatment (OR: 1.29; 95% CI: 1.00–1.66) were independently associated with hospital readmission. The rate of readmission after hospital discharge for COVID-19 was low. Advanced age and comorbidity were associated with increased risk of readmission.

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Higher albumin levels on admission predict better prognosis in patients with confirmed COVID-19

Cited by 65 publications

References 43 publications

Study of serum albumin as a marker of severity in COVID-19 positive SARI and COVID-19 negative SARI patients

Study of serum albumin as a marker of severity in COVID-19 positive SARI and COVID-19 negative SARI patients

Low serum albumin and the risk of hospitalization in COVID-19 infection: A retrospective case-control study

Frequency, risk factors, and outcomes of hospital readmissions of COVID-19 patients

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