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Decreased serum albumin level indicates poor prognosis of COVID-19 patients: hepatic injury analysis from 2,623 hospitalized cases.
Huang, Wei; Li, Chenze; Wang, Zhiquan; Wang, Hong; Zhou, Ning; Jiang, Jiangang; Ni, Li; Zhang, Xin A; Wang, Dao-Wen.
  • Huang W; Division of Cardiology, Department of Internal Medicine, and Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430010, China.
  • Li C; Department of Cardiology, Chinese PLA Central War Command General Hospital, Wuhan, 430010, China.
  • Wang Z; Division of Cardiology, Department of Internal Medicine, and Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430010, China.
  • Wang H; Department of Cardiology, Chinese PLA Central War Command General Hospital, Wuhan, 430010, China.
  • Zhou N; Division of Cardiology, Department of Internal Medicine, and Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430010, China.
  • Jiang J; Division of Cardiology, Department of Internal Medicine, and Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430010, China.
  • Ni L; Division of Cardiology, Department of Internal Medicine, and Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430010, China.
  • Zhang XA; Division of Cardiology, Department of Internal Medicine, and Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430010, China.
  • Wang DW; Stephenson Cancer Center and Department of Physiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA.
Sci China Life Sci ; 63(11): 1678-1687, 2020 11.
Article in English | MEDLINE | ID: covidwho-610883
Semantic information from SemMedBD (by NLM)
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Patients
2. Hospitals LOCATION_OF Retrospective Studies
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Retrospective Studies
3. Critical Illness PROCESS_OF Patients
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Critical Illness
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Patients
4. Critical Illness PROCESS_OF Survivors
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Survivors
5. Hospitals LOCATION_OF Study
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6. serum LDL DIAGNOSES Critical Illness
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serum LDL
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DIAGNOSES
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Critical Illness
7. Serous inflammation PROCESS_OF Patients
Subject
Serous inflammation
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PROCESS_OF
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Patients
8. Hypoalbuminemia AFFECTS Inflammatory Response
Subject
Hypoalbuminemia
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AFFECTS
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Inflammatory Response
9. Exacerbation COEXISTS_WITH Hypoalbuminemia
Subject
Exacerbation
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COEXISTS_WITH
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Hypoalbuminemia
10. Disease CAUSES Cessation of life
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Cessation of life
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16. serum LDL DIAGNOSES Critical Illness
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serum LDL
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ABSTRACT
Coronavirus disease 2019 (COVID-19) is a global pandemic which has caused numerous deaths worldwide. The present study investigated the roles of hypoproteinemia in the clinical outcome and liver dysfunction of COVID-19 patients. In this retrospective study, we extracted data from 2,623 clinically confirmed adult COVID-19 patients (>18 years old) between January 29, 2020 and March 6, 2020 in Tongji Hospital, Wuhan, China. The patients were divided into three groups-non-critically ill, critically ill, and death groups-in accordance with the Chinese Clinical Guideline for COVID-19. Serum albumin, low-density lipoproteins cholesterol (LDL-C), and high-density lipoproteins cholesterol (HDL-C) concentrations and inflammatory cytokines levels were measured and compared among these three groups. The median age of these 2,623 patients was 64 years old (interquartile range (IQR), 52-71). Among the patients enrolled in the study, 2,008 (76.6%) were diagnosed as non-critically ill and 615 (23.4%) were critically ill patients, including 383 (14.6%) critically ill survivors and 232 (8.8%) critically ill deaths in the hospital. Marked hypoalbuminemia occurred in 38.2%, 71.2%, and 82.4% patients in non-critically ill, critically ill, and death groups, respectively, on admission and 45.9%, 77.7%, and 95.6% of these three groups, respectively, during hospitalization. We also discovered that serum low-density lipoprotein (LDL) and HDL levels were significantly lower in critically ill and death groups compared to non-critically ill group. Meanwhile, the patients displayed dramatically elevated levels of serum inflammatory factors, while a markedly prolonged activated partial thromboplastin time (APTT) in critically ill patients reflected coagulopathy. This study suggests that COVID-19-induced cytokine storm causes hepatotoxicity and subsequently critical hypoalbuminemia, which are associated with exacerbation of disease-associated inflammatory responses and progression of the disease and ultimately leads to death for some critically ill patients.
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Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Coronavirus Infections / Serum Albumin, Human / COVID-19 / Liver Diseases Type of study: Etiology study / Clinical Practice Guide / Observational study / Prognostic study / Randomized controlled trials / Risk factors Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: English Journal: Sci China Life Sci Journal subject: Biology / Science Year: 2020 Document Type: Article Affiliation country: S11427-020-1733-4

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Coronavirus Infections / Serum Albumin, Human / COVID-19 / Liver Diseases Type of study: Etiology study / Clinical Practice Guide / Observational study / Prognostic study / Randomized controlled trials / Risk factors Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: English Journal: Sci China Life Sci Journal subject: Biology / Science Year: 2020 Document Type: Article Affiliation country: S11427-020-1733-4