Hypoalbuminemia predicts the outcome of COVID‐19 independent of age and co‐morbidity

Abstract

The coronavirus disease 2019 has evolved into a pandemic rapidly. Most of the literature show that the elevated liver enzymes in COVID-19 are of little clinical significance. Lower albumin level is seen in severe COVID-19 and is not parallel to the changes in alanine aminotransferase and aspartate aminotransferase levels. We aimed to explore the impact of hypoalbuminemia in COVID-19. This retrospective cohort study included adult patients with confirmed COVID-19. The relationship between hypoalbuminemia and death was studied using binary logistic analysis. A total of 299 adult patients were included, 160 (53.5%) were males and the average age was 53.4 ± 16.7 years. The median time from the onset of illness to admission was 3 days (interquartile ranges, 2-5). Approximately one-third of the patients had comorbidities.Hypoalbuminemia (<35 g/L) was found in 106 (35.5%) patients. The difference in albumin was considerable between survivors and non-survivors (37.6 ± 6.2 vs 30.5 ± 4.0, P < .001). Serum albumin level was inversely correlated to white blood cell (r = -.149, P = .01) and neutrophil to lymphocyte ratio (r = −.298, P < .001). Multivariate analysis showed the presence of comorbidities (OR, 6.816; 95% CI, lymphopenia (OR, 13.130; 95% CI,) and hypoalbuminemia (OR, 6.394; 95% CI, 1.315-31.092) were independent predictive factors for mortality. In conclusion, hypoalbuminemia is associated with the outcome of COVID-19. The potential therapeutic value of albumin infusion in COVID-19 should be further explored at the earliest.

Clinical Characteristics and Risk Factors of Disseminated Intravascular Coagulation in Patients with COVID-19

“…25 Furthermore, the decreased level of ALB suggests the hypercoagulable state and blood clots condition, which increases the risk of adverse clinical outcomes in COVID-19 patients. 26 In addition, we found that some patients with DIC had hypoxia on admission. Hypoxia deregulates platelet function through enhancement of platelet adhesion, aggregation, and release, which ultimately activates intravascular coagulation and causes the formation of thrombus.…”

Hypoalbuminemia&nbsp;in Severe COVID-19&nbsp;Post&nbsp;Recovery&nbsp;Patients

“…Although the mechanisms for hypoalbuminemia in COVID-19 have not been studied thoroughly 24 , albumin is a major serum protein produced by hepatic cells 24,25 and has a critical role in human health.…”

Exploiting an early warning nomogram for predicting the risk of ICU admission in COVID-19 patients: A multi-center study in China

“…In most prognostic prediction models that have been published, older age, comorbidities, and increases in lactate dehydrogenase, lymphocyte, and C-reactive protein levels were the risk factors for poor prognosis [25]. Other indicators such as heart rate; breath rate; oxygen saturation; levels of procalcitonin, direct bilirubin, albumin, and D-dimer levels; activated partial thromboplastin time; glomerular ltration rate; and chest radiography abnormality have controversial conclusions [35,36]. Our study also demonstrated that patients with COVID-19 infection who were older (especially >65 years) had a worse prognosis than younger patients.…”