Background: Several studies have reported profound altered serum albumin level status among patients with COVID-19 disease. Hence, the current study aimed to evaluate the plasma albumin status levels and to establish the relationship between serum albumin level status and markers of hepato-biliary dysfunction and systemic inflammation among COVID-19 patients of African origin. Methods: This was a retrospective study of pre-treatment data obtained from patients with confirmed real-time reverse transcription-polymerase chain reaction COVID-19 disease in Eleme COVID-19 treatment center, Port Harcourt, Southern Nigeria. Data were obtained from each patients' case notes, medical review charts, nurses' vital signs/medication charts, laboratory records, and archived data from the electronic medical records using trained research assistants at the treatment center. The data extraction was done using validated data collection templates. Data analysis was done using standard protocols. Results: Among the 473 studied cases, 112 (23.7%) had normal plasma albumin status while 361 (76.3%) had low plasma albumin status. Among the low plasma albumin status subgroups, 57.6% and 42.4% had clinically insignificant and clinically significant low plasma albumin status levels, respectively. No difference was observed in the mean plasma levels/activities of all the markers of hepato-biliary dysfunctions between the subjects with normal and low albumin status levels and also between the clinically insignificant and clinically significant low plasma albumin status subgroups (p>0.05). However, a statistically significant difference was observed in the mean plasma levels of all the systemic inflammatory markers between the subjects with normal and low albumin status levels as well as between the clinically insignificant and clinically significant low plasma albumin status subgroups (p<0.05). Furthermore, no statistically significant relationship existed between the plasma albumin status levels and all the markers of hepato-biliary dysfunctions (p>0.05). However, significant inverse relationships existed between plasma albumin status levels and all the systemic inflammatory markers/indices (p<0.05). Conclusion: The present study indicates that low plasma albumin level status is common among COVID-19 patients and correlates significantly with systemic inflammation. Since COVID-19 is invariably associated with systemic inflammation, albumin may have therapeutic value in COVID-19 management. However, further studies are highly recommended.
Background: Disorders of electrolytes balance, especially that of potassium, have frequently been documented among patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. However, most of these reports have been documented among the western populations. Hence, this current study was aimed to evaluate the pattern of derangement in potassium balance and its correlation to other clinical and laboratory variables among Nigerians. Methods: Archived data of all eligible adult patients, who were managed at the Eleme treatment center in Port Harcourt, Nigeria following a positive real-time reverse-transcriptase polymerase chain reaction (RT-PCR) test for SARS-CoV-2 infection, were enrolled for this study. All relevant data of enrolled subjects were retrieved from the archived case notes, medical review charts, nurses' charts, and laboratory-related records at initial presentation before any form of medical treatment by trained research assistants using well-structured data extraction forms. The collected data was analyzed using descriptive and comparative statistics. Results: Hypokalemia was recorded in 323 (62.8%) subjects out of a total of 515 eligible subjects. Mild, moderate, and severe hypokalemia was recorded among 32 (9.9%), 219 (67.9%), and 72 (22.2%) subjects, respectively. The subjects with severe hypokalemic status were mostly males and also of older age and had significantly higher systolic blood pressure, CRP, D-dimer, neutrophil count, and higher proportions of those with severe SARS-CoV-2 infection but lower albumin levels, lymphocyte and platelet counts compared to those with mild and moderate hypokalemic status (p<0.05). Inverse relationships were established between plasma potassium status and systolic blood pressure, sodium, C-reactive protein, D-dimer, and neutrophil count. While a significant positive relationship was observed between plasma potassium status and plasma albumin, lymphocyte counts, platelet counts, and oxygen saturation among the hypokalemic subjects (p<0.05). Compare to mild and moderate hypokalemic status, severe hypokalemic status was associated with severe SARS-CoV-2 infection (OR: 5.671; (95%CI: 4.467-7.365); p<0.001) and unfavorable clinical outcomes (OR: 7.863; (95%CI: 6.502-9.342); p<0.001) among the hypokalemic subjects. Conclusion: The present study findings suggest a high frequency of hypokalemia among subjects with the SARS-CoV-2 infection who are mostly males and of older age. The observed hypokalemia, especially the severe variant, was found in association with the severe infection and unfavorable clinical outcome. These findings should be considered during the management of SARS-CoV-2 infection. However, further studies are recommended to verify the conclusions of the present study.
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