Serum Albumin Levels are a Predictor of COVID-19 Patient Prognosis: Evidence from a Single Cohort in Chongqing, China

Abstract

Background COVID-19 infections are still at pandemic levels globally and there are currently no specific drugs to treat these infections. Previous studies have demonstrated that serum albumin levels were abnormally low in COVID-19 patients and might be used as a prognosis biomarker. Supplemental albumin has been used as an experimental therapeutic method. However, dynamic evaluation of albumin in patients with COVID-19 was limited and whether serum albumin could predict the prognosis of these patients is unknown. Methods We enrolled 79 COVID-19 patients in the present study and reviewed electronic medical laboratory records. Data was processed using SPSS software (Version 20.0) and correlation analysis was performed between serum albumin and other clinical and laboratory findings. Results Serum albumin levels were gradually decreased both in severe and non-severe COVID-19 patients. Moreover, 17.7% of the patients presented with hypoalbuminemia at least one time during 3 consecutive weekly time points. The hypoalbuminemia group displayed more severe disease and comorbidity that included fever, fatigue, headache, and dizziness on admission. Moreover, serum albumin levels were positively correlated with lymphocyte and RBC numbers, Hb and prealbumin levels as well as with total T cell numbers and the presence of CD4 + and CD8 + T cells. In contrast, there was a negative correlation with C-reactive protein levels and this was an indicator of patient recovery. Conclusion Our results demonstrated that hypoalbuminemia was common in COVID-19 patients and its levels were linked to disease severity. Patients with fever, fatigue and headache or dizziness on admission were more likely to experience hypoalbuminemia. Dynamic monitoring of serum albumin is therefore necessary and should be performed during COVID-19 patient treatments as a tool for evaluating the prognosis of COVID-19 infections.

A Diagnostic Model to Predict SARS-CoV-2 Positivity in Emergency Department Using Routine Admission Hematological Parameters

“…In the prospective cohort, the CS was >8 in 100% of cases, even in the 12% of patients with a first false negative RT-PCR result, confirming its high positive predictive value, even beyond RT-PCR. Furthermore, while, as previously reported, increasing values of PCR [23], LDH [24], ddimer [24,25], DELR, PCR/albumin [26] and decreasing values of albumin serum level [27] at admission showed significant correlation with disease severity, CS resulted to be not correlated neither with the number of days from symptoms onset nor with disease severity itself, assessed on the basis of specific integrated criteria based on respiratory function, symptoms and radiological findings, thus reinforcing its screening power and its independent high sensibility.…”

Potential Role of Certain Biomarkers Such as Vitamin B12, ROS, Albumin, as Early Predictors for Prognosis of COVID-19 Outcomes

“…Phosphorus shows a statistically significant decrease after the initial stage (p < 0.05) when the infection begins to become more apparent. The available literature also shows that hypoalbuminemia in patients with COVID-19 is associated with an excessive increase in inflammatory cytokines, coagulation parameters as well as the progression to more severe stages of the disease involving an increased need for hospitalization [17]. Thus, in our study, total albumin as well as albumin show a downward course (p < 0.001), from the onset of the disease and throughout its duration, depending on its severity.…”

“…Overall, whether albumin administration to patients with COVID-19 is beneficial, is currently unknown. In addition to the therapeutic role of albumin, a number of studies have used albumin levels as a prognostic tool in patients with SARS-CoV-2 infection [17]. Consequently, studying the clinical and biochemical factors and characteristics between COVID-19 survivors and the deceased, may guide clinicians to identify severe cases at a very early stage of the disease and facilitate appropriate treatment.…”

COVID‐19 vulnerabilities are intensified by declining human serum albumin levels

“…The main known factor affecting vulnerabilities to COVID-19 is the availability of nutrient-bound ligand carriers, but present methods of human serum albumin (HSA) therapy are insufficient to prevent morbidity (Boada et al, 2019;Caraceni et al, 2013). Furthermore, a recent paper by Xu et al (2021, Kheir et al, 2021 demonstrates that low serum albumin levels are a predictor of COVID-19 vulnerability. They studied a cohort of 79 COVID-19 patients combined with a review of electronic laboratory records.…”

“…Furthermore, a recent paper by Xu et al. (2021, Kheir et al., 2021) demonstrates that low serum albumin levels are a predictor of COVID‐19 vulnerability. They studied a cohort of 79 COVID‐19 patients combined with a review of electronic laboratory records.…”