Biomark Med undefined

PMC: PMC7273900

PMID: 32490680

Plasma albumin levels predict risk for nonsurvivors in critically ill patients with COVID-19

^{Department of Pharmacy, Key Laboratory for Molecular Diagnosis of Hubei Province, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei 430021, China}

^{Department of Endocrinology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei 430021, China}

^{Department of Pulmonary & Critical Care Medicine, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei 430021, China}

^{Department of Radiology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei 430021, China}

^{Department of Pain, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei 430021, China}

^{Author for correspondence: Tel.: +86 278 220 1722;}moc.361@1007mhz

^{Author for correspondence:}moc.621@22712yc

^{Authors contributed equally}

Received 2020 Apr 27; Accepted 2020 May 20.

This work is licensed under the Creative Commons Attribution 4.0 License

Abstract

Aim: We aimed to explore the biomarkers for disease progression or the risk of nonsurvivors. Materials & methods: This study included 134 hospitalized patients with confirmed COVID-19 infection. The outcome of moderate versus severe versus critically ill patients and survivors versus nonsurvivors were compared. Results: An increase in the severity of COVID-19 pneumonia was positively associated with lower levels of platelets and albumin (all p < 0.05). In the critical group, the plasma levels of albumin continued to have a significant association for the risk of nonsurvivors (p < 0.05), even after adjusting for confounding factors. Conclusion: Albumin levels could be used as an independent predictor of the risk of nonsurvivors in critically ill patients with COVID-19.

Keywords: : albumin, biomarkers, COVID-19, critically ill patients, infection, pneumonia

A series of unexplained pneumonia cases (with a history of work or residence around the Huanan seafood wholesale market) were admitted to a hospital in Wuhan, Hubei province, China. Their clinical presentations were similar to viral pneumonia and some patients rapidly developed life-threatening acute respiratory diseases (ARDS) [1]. A novel coronavirus was then identified by sequencing the whole genome of the virus isolated from the patients and was named COVID-19 by the WHO [2,3]. To date, more than 80,000 confirmed cases have been identified in 34 provinces of China, more than 49,000 are from Wuhan city and the virus has been found in Japan, Thailand, South Korea, USA, etc [4,5].

Generally, the majority of COVID-19-positive patients are present with general symptoms of respiratory infection with a case fatality rate of 1.4–4% [3,6,7]. In some cases that develop severe or critical illness, death may be due to massive alveolar damage and progressive respiratory failure, with a higher mortality rate (38–60%) [8,9]. However, little is known regarding the clinical markers for the risk of nonsurvivors in patients with COVID-19.

The purpose of this study was to explore biomarkers for disease progression and the risk of nonsurvivors. We hope that our research will help clinicians identify patients with a high risk of nonsurvivors at an early stage.

CT: Computed tomography.

OR: Odds ratio.

Author contributions

H Zhang and Y Cai had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. H Zhang and Y Cai also conceived and designed the experiments. J Li, ML Li, S Zheng, M Sun, Y Cai and H Zhang performed the experiments. J Li, M Li, X Li and A Deng analyzed the data. J Li wrote the paper. J Li, M Li, S Zheng and ML Li contributed equally.

Acknowledgments

We thank all health-care workers involved in the diagnosis and treatment of patients in Wuhan.

Financial & competing interests disclosure

This study was supported by the Health and Family Planning Commission of Wuhan City (WX18M02 and WX18C25). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

This study was approved by the Ethics Commission of the Central Hospital of Wuhan. Written informed consent was waived for retrospective study. The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.

Data availability

The data used to support the findings of this study are included within the article.

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