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Higher albumin levels on admission predict better prognosis in patients with confirmed COVID-19.
Kheir, Matthew; Saleem, Farah; Wang, Christy; Mann, Amardeep; Chua, Jimmy.
  • Kheir M; Department of Medicine, Trios Health- A University of Washington Medicine Community Health Partner, Kennewick, Washington, United States of America.
  • Saleem F; Department of Medicine, Trios Health- A University of Washington Medicine Community Health Partner, Kennewick, Washington, United States of America.
  • Wang C; Department of Medicine, Trios Health- A University of Washington Medicine Community Health Partner, Kennewick, Washington, United States of America.
  • Mann A; Department of Cardiology, Lourdes Medical Center, Pasco, Washington, United States of America.
  • Chua J; Department of Infectious Diseases, Trios Health- A University of Washington Medicine Community Health Partner, Kennewick, Washington, United States of America.
PLoS One ; 16(3): e0248358, 2021.
Article in English | MEDLINE | ID: covidwho-1136296
ABSTRACT

BACKGROUND:

Research surrounding COVID-19 (coronavirus disease 2019) is rapidly increasing, including the study of biomarkers for predicting outcomes. There is little data examining the correlation between serum albumin levels and COVID-19 disease severity. The purpose of this study is to evaluate whether admission albumin levels reliably predict outcomes in COVID-19 patients.

METHODS:

We retrospectively reviewed 181 patients from two hospitals who had COVID-19 pneumonia confirmed by polymerase chain reaction (PCR) testing and radiologic imaging, who were hospitalized between March and July 2020. We recorded demographics, COVID-19 testing techniques, and day of admission labs. The outcomes recorded included the following venous thromboembolism (VTE), acute respiratory distress syndrome (ARDS), intensive care unit (ICU) admission, discharge with new or higher home oxygen supplementation, readmission within 90 days, in-hospital mortality, and total adverse events. A multivariate modified Poisson regression analysis was then performed to determine significant predictors for increased adverse events in patients with COVID-19 pneumonia.

RESULTS:

A total of 109 patients (60.2%) had hypoalbuminemia (albumin level < 3.3 g/dL). Patients with higher albumin levels on admission had a 72% decreased risk of developing venous thromboembolism (adjusted relative risk [RR]0.28, 95% confidence interval [CI]0.14-0.53, p<0.001) for every 1 g/dL increase of albumin. Moreover, higher albumin levels on admission were associated with a lower risk of developing ARDS (adjusted RR0.73, 95% CI0.55-0.98, p = 0.033), admission to the ICU (adjusted RR0.64, 95% CI0.45-0.93, p = 0.019), and were less likely to be readmitted within 90 days (adjusted RR0.37, 95% CI0.17-0.81, p = 0.012). Furthermore, higher albumin levels were associated with fewer total adverse events (adjusted RR0.65, 95% CI0.52-0.80, p<0.001).

CONCLUSIONS:

Admission serum albumin levels appear to be a predictive biomarker for outcomes in COVID-19 patients. We found that higher albumin levels on admission were associated with significantly fewer adverse outcomes, including less VTE events, ARDS development, ICU admissions, and readmissions within 90 days. Screening patients may lead to early identification of patients at risk for developing in-hospital complications and improve optimization and preventative efforts in this cohort.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Serum Albumin / COVID-19 Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2021 Document Type: Article Affiliation country: Journal.pone.0248358

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Serum Albumin / COVID-19 Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2021 Document Type: Article Affiliation country: Journal.pone.0248358