Blood volume and albumin transudation in critically ill COVID-19 patients

Bakker, Jan; Horowitz, James; Hagedorn, J.; Kozloff, Sam; Kaufman, David A.; Castro, Ricardo

doi:10.1186/s13054-021-03699-y

Cited by 8 publications

(3 citation statements)

References 6 publications

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“…However, various considerations can be noted. From a pathogenetic point of view, endothelial dysfunction plays an important role in COVID-19 [ 15 ]. Endothelial dysfunction is the result of several mechanisms, including reaction to SARS-CoV-2, as well as to hypoxia, activation and recruitment of immune cells with the production of inflammatory mediators.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Serum Albumin Levels on COVID-19 Mortality

Zerbato

Sanson

Luca

et al. 2022

Infectious Disease Reports

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Low serum albumin (SA) correlates with mortality in critically ill patients, including those with COVID-19. We aimed to identify SA thresholds to predict the risk of longer hospital stay, severe respiratory failure, and death in hospitalized adult patients with COVID-19 pneumonia. A prospective longitudinal study was conducted at the Infectious Diseases Unit of Trieste University Hospital (Italy) between March 2020 and June 2021. The evaluated outcomes were: (1) need of invasive mechanical ventilation (IMV); (2) length of hospital stay (LOS); and (3) 90-day mortality rate. We enrolled 864 patients. Hypoalbuminemia (<3.5 g/dL) was detected in 586 patients (67.8%). SA on admission was significantly lower in patients who underwent IMV (2.9 vs. 3.4 g/dL; p < 0.001). The optimal SA cutoff predicting the need of IMV was 3.17 g/dL (AUC 0.688; 95% CI: 0.618–0.759; p < 0.001) and this threshold appeared as an independent risk factor for the risk of IMV in multivariate Cox regression analysis. The median LOS was 12 days and a higher SA was predictive for a shorter LOS (p < 0.001). The overall 90-day mortality rate was 15%. SA was significantly lower in patients who died within 90 days from hospital admission (3.1 g/dL; IQR 2.8–3.4; p < 0.001) as compared to those who survived (3.4 g/dL; IQR 3.1–3.7). The optimal SA threshold predicting high risk of 90-day mortality was 3.23 g/dL (AUC 0.678; 95% CI: 0.629–0.734; p < 0.001). In a multivariate Cox regression analysis, SA of <3.23 g/dL appeared to be an independent risk factor for 90-day mortality. Our results suggest that low SA on admission may identify patients with COVID-19 pneumonia at higher risk of severe respiratory failure, death, and longer LOS. Clinicians could consider 3.2 g/dL as a prognostic threshold for both IMV and mortality in hospitalized COVID-19 patients.

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Section: Discussionmentioning

confidence: 99%

The Impact of Serum Albumin Levels on COVID-19 Mortality

Zerbato

Sanson

Luca

et al. 2022

Infectious Disease Reports

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“…This procedure causes the epithelial-endothelial barrier to lose its structural strength, allowing peptides and liquids, including hypoalbuminemia, to move from the intra-vascular to the extra-vascular segment and cause hypoalbuminemia. Thus, in COVID-19 individuals, hypoalbuminemia may be a sign of epithelial-endothelial injury (25).…”

Section: Discussionmentioning

confidence: 99%

Predictors of Mortality of Covid-19 Infected Patients With Acute Kidney Injury

Nariswari,

Tandarto,

Tjempakasari

2023

JUMMEC

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Introduction: Coronavirus disease 2019 (COVID-19) is a condition brought on by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) where this virus is highly contagious. In several studies, acute kidney injury was associated with the cause of death. This study aimed to analyze what factors played a role as predictors of mortality in COVID-19 patients who experienced acute kidney injury. Method: This study used a one-center retrospective cohort method where the study was conducted at Dr. Soetomo General Academic Teaching Hospital, Surabaya, Indonesia. Statistical analysis of multivariate logistic regression was performed, and the results were presented in the form of an odds ratio (OR), with a p-value considered significant < 0.05 and a 95% confidence interval. Results: A total of 498 COVID-19 patients with acute kidney injury were included in this study. Our research found that 153 subjects (30.7%) died. The results of multivariate logistic regression analysis showed that the largest OR value was the D-dimer value variable, namely 2.102 (95% CI: 1.361-3.247), which means that COVID-19 patients with acute kidney injury who have a D-dimer value of ≥ 1.2 mg/L have the possibility of experiencing mortality within 30 days was 2.1 times greater than in patients with D-dimer values < 1.2 mg/L. The next variables were albumin value < 3.5 g/dL (OR 2.015, 95% CI: 0.992-4.091), history of hypertension (OR 2.003, 95% CI: 1.343-2.988). Conclusion: Our study found that a history of hypertension, higher than normal D-dimer levels, and hypoalbuminemia were predictors of mortality in patients with acute kidney injury who were infected with COVID-19.

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“…As mentioned, BVA can provide information about albumin transudation rate based on the dilution of tracer over time. In an interesting case series including 4 critically ill patients with COVID-19, Bakker et al [55] to assess capillary permeability . Larger studies are needed to understand how this information can be utilized to titrate therapy.…”

Section: Quantitative Blood Volume Analysismentioning

confidence: 99%

Diagnosis of Fluid Overload: From Conventional to Contemporary Concepts

Koratala¹,

Ronco²,

Kazory³

2022

Cardiorenal Med

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Fluid overload has been associated with morbidity and mortality in various clinical scenarios including heart failure and critical illness. It exerts pathologic sequelae in almost all the organ systems. Proper management of patients with fluid overload requires knowledge of the underlying pathophysiology, objective evaluation of volume status, selection of appropriate therapeutic options, and maintenance and modulation of tissue perfusion. There are several methods to appraise volume status but none without limitations. In this review, we discuss the diagnostic utility, prognostic significance, and shortcomings of various bedside tools in the detection of fluid overload and evaluation of hemodynamic status. These include clinical examination, biomarkers, blood volume assessment, bioimpedance analysis, point-of-care ultrasound, and remote pulmonary pressure monitoring. In our opinion, clinicians must adopt a multiparametric approach offsetting the limitations of individual methods to formulate a management plan tailored to patients’ needs.

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Blood volume and albumin transudation in critically ill COVID-19 patients

Cited by 8 publications

References 6 publications

The Impact of Serum Albumin Levels on COVID-19 Mortality

The Impact of Serum Albumin Levels on COVID-19 Mortality

Predictors of Mortality of Covid-19 Infected Patients With Acute Kidney Injury

Diagnosis of Fluid Overload: From Conventional to Contemporary Concepts

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