Is Albumin Predictor of Mortality in COVID-19?
Francesco Violi, Roberto Cangemi, Giulio Francesco Romiti, Giancarlo Ceccarelli, Alessandra Oliva, Francesco Alessandri, Matteo Pirro, Pasquale Pignatelli, Miriam Lichtner, Anna Carraro, Francesco Cipollone, Damiano D’Ardes, Francesco Pugliese, Claudio Maria Mastroianni
Abstract
Coronavirus 2019 (COVID-19) is a pandemic associated with a high risk of mortality. Human serum albumin (HSA) is an acute phase reactant with antioxidant property; however, its behavior and impact on survival in COVID-19 patients have never been studied so far. Among 319 COVID-19 patients followed up for a median of 19 days, 64 died. Compared with survivors, nonsurvivors had more prevalence of intensive care unit (ICU) admission, chronic obstructive pulmonary disease (COPD), heart failure, elevated levels of D-dimer, high-sensitivity C reactive protein (hs-CRP) and troponins, and lower values of albumin. At the Cox regression analysis, albumin (hazard ratio [HR]: 0.38, 95% confidence interval [CI]: 0.23–0.63, p < 0.001) and age (HR: 1.03, 95% CI: 1.01–1.06, p = 0.001) were independently associated with mortality, irrespective of adjustment for gender, ICU admission, heart failure, COPD, and hs-CRP levels. Our observation leads to the hypothesis that HSA analysis may be used to identify patients at higher risk of death in COVID-19 patients.