Hypoalbuminemia on admission in COVID-19 infection: An early predictor of mortality and adverse events. A retrospective observational study

Viana-Llamas, María C; Arroyo-Espliguero, Ramón; Silva-Obregón, J. Alberto; Uribe-Heredia, G; Núñez‐Gil, Iván J.; García-Magallón, B; Torán-Martínez, C; Castillo-Sandoval, A; Díaz-Caraballo, Eva; Rodríguez-Guinea, Itsaso; Domínguez-López, Jesús

doi:10.1016/j.medcli.2020.12.018

Cited by 44 publications

(34 citation statements)

References 27 publications

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“…In a meta-analysis of Chinese studies, Aziz and colleagues concluded that there was an association of hypoalbuminemia and severe COVID-19 [ 9 ]. Subsequently, other studies have shown that these findings also occur in the Caucasian population [ 7 , 10 , 11 ]. Specifically in Spain, Viana-Llamas and colleagues found that low albumin levels were an early predictor of mortality during hospitalization among 609 Spanish patients admitted due to COVID-19, independently of age, comorbidity and inflammatory markers [ 11 ].…”

Section: Discussionmentioning

confidence: 71%

“…Subsequently, other studies have shown that these findings also occur in the Caucasian population [ 7 , 10 , 11 ]. Specifically in Spain, Viana-Llamas and colleagues found that low albumin levels were an early predictor of mortality during hospitalization among 609 Spanish patients admitted due to COVID-19, independently of age, comorbidity and inflammatory markers [ 11 ]. Moreover, de la Rica et al., concluded that hypoalbuminemia was related to longer hospital length and greater mortality in 48 COVID-19 patients hospitalized in the Balearic Islands [ 10 ].…”

Section: Discussionmentioning

confidence: 71%

“…Since the beginning of this pandemic, efforts have focused on detecting markers of poor prognosis, not only clinical but also biochemical. In this sense, although its mechanism is not well defined, low albumin levels have been shown to predict poor clinical outcomes among patients admitted due to a SarS-CoV-2 infection [ [7] , [8] , [9] , [10] , [11] , [12] , [13] ]. However, the majority of these studies have been carried out in the Asian population, without knowing the real effect in the Caucasian population.…”

Section: Introductionmentioning

confidence: 99%

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The coexistence of low albumin levels and obesity worsens clinical outcomes among subjects admitted for sars-cov-2 infection

Nicolau¹,

Ayala²,

Sanchís

et al. 2021

Clinical Nutrition ESPEN

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Background and aims The clinical spectrum of the SARS-CoV-2 infection is very broad, ranging from asymptomatic infection to severe pneumonia. However, the majority of fatalities related to COVID-19 have involved old, frail and patients with comorbidities, such as obesity, groups that also have high rates of a poor nutritional status. To assess the impact on clinical outcomes of the coexistence of any degree of obesity and low albumin levels on admission among patients with COVID-19. Methods This is a sub-analysis of a former study where 75 patients admitted due to COVID-19 were evaluated cross-sectionally. In this analysis, patients were divided in two groups, according to the presence of obesity and albumin levels on admission lower than 3.5 g/dl. Results 11 out 75 patients evaluated (14.7%) had obesity and albumin levels lower than 3.5 g/dl. Patients with obesity and hypoalbuminemia were older than patients without these two conditions (65.3 ± 7.7 vs 54.2 ± 17 years; p = 0.01). CRP (141.4 ± 47.9 vs 70.1 ± 60.6 mg/l; p = 0.002), D-dimer (2677.3 ± 2358.3 vs 521.7 ± 480.3 ng/ml; p = 0.001), fibrinogen (765.9 ± 123.9 vs 613.5 ± 158gr/L; p = 0.007) ferritin levels (903.1 ± 493 vs 531.4 ± 418.9 mcg/l; p = 0.01) and procalcitonin (3.5 ± 0.6 vs 1.1 ± 0.7 ng/ml; p = 0.009) were significantly higher in the group with obesity and hypoalbuminemia. Among patients with low albumin and obesity, length of hospital was higher (21.9 ± 18.7 vs 10.5 ± 9.5 days; p = 0.004) and the proportion of subjects admitted to ICU was greater (81.8% vs 11.5%; p < 0.0001). However, mortality rates were comparable between the two groups (3.8% vs 0%; p = 0.5). Conclusions The combination of obesity and hypoalbuminemia may worsen the prognosis of patients with a SARS-CoV-2 infection. Therefore, prompt identification and amelioration of nutritional status could be beneficial.

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Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 71%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The coexistence of low albumin levels and obesity worsens clinical outcomes among subjects admitted for sars-cov-2 infection

Nicolau¹,

Ayala²,

Sanchís

et al. 2021

Clinical Nutrition ESPEN

View full text Add to dashboard Cite

show abstract

“…Serum albumin has been shown to decrease in many acute and chronic diseases related to the magnitude of the inflammatory response they generate. 43 Elevated GLR represents increased serum glucose and lower lymphocytes counts but cannot reflect lower serum ALB levels, as lower serum ALB levels may reflect hypoglycemia and increased inflammatory response.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Glucose-to-Lymphocyte Ratio in Critically Ill Patients with Acute Pancreatitis

Chen¹,

Tang²,

Wang³

2021

IJGM

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Background: Glucose metabolism and systemic inflammation have been associated with prognosis in acute pancreatitis (AP) patients. However, the possible value as a prognostic marker of the glucose-to-lymphocyte ratio (GLR) has not been evaluated in critically ill patients with AP. Methods: This study included 1,133 critically ill patients with AP from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database, who were randomly divided into the training cohort (n=806) and the validation cohort (n=327) at a ratio of 7:3. X-tile software was used to determine the optimal cut-off values for GLR. Area under the curve (AUC) analysis was performed to compare the performance between GLR and other bloodbased inflammatory biomarkers. Univariate and multivariate Cox regression analyses were applied to select prognostic factors associated with in-hospital mortality. A nomogram model was developed based on the identified prognostic factors and the validation cohort was used to further validate the nomogram. Results: The optimal cut-off value for GLR was 0.9. The ROC analyses showed that the discrimination abilities of GLR were better than other blood-based inflammatory biomarkers. Multivariate Cox regression analysis demonstrated that age, platelet, albumin, bilirubin, Sequential Organ Failure Assessment (SOFA) score, and GLR are independent predictors of poor overall survival in the training cohort and were incorporated into the nomogram for in-hospital mortality as independent factors. The nomogram exhibited better discrimination with C-indexes in the training cohort and the validation cohort of 0.886 (95% CI=0.849-0.922) and 0.841 (95% CI=0.767-0.915), respectively. The calibration plot revealed an adequate fit of the nomogram for predicting the risk of in-hospital mortality in both sets. Conclusion:As an easily available biomarker, GLR can independently predict the inhospital mortality of critically ill patients with AP. The nomogram combining GLR with other significant features exerted favorable predictive performance for in-hospital mortality.

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“…The albumin levels are also decreased in COVID-19 patients and are positively correlated with the infection severity[ 81 ]. Zhang et al [ 82 ] found that 54.78% of COVID-19 patients (63/115) present hypoalbuminemia and among the severe COVID-19 patients, the percentage is 90.32%.…”

Section: Malnutritional Risk and Nutritional Intervention In Covid-19 Patientsmentioning

confidence: 99%

COVID-19 and its effects on the digestive system

Cao¹,

Zhang²,

Pellegrini³

et al. 2021

WJG

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Coronavirus disease 2019 (COVID-19) is caused by infection of the coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with typical respiratory symptoms. SARS-CoV-2 invades not only the respiratory system, but also other organs expressing the cell surface receptor angiotensin converting enzyme 2. In particular, the digestive system is a susceptible target of SARS-CoV-2. Gastrointestinal symptoms of COVID-19 include anorexia, nausea, vomiting, diarrhea, abdominal pain, and liver damage. Patients with digestive damage have a greater chance of progressing to severe or critical illness, a poorer prognosis, and a higher risk of death. This paper aims to summarize the digestive system symptoms of COVID-19 and discuss fecal-oral contagion of SARS-CoV-2. It also describes the characteristics of inflammatory bowel disease patients with SARS-CoV-2 infection and discusses precautions for preventing SARS-CoV-2 infection during gastrointestinal endoscopy procedures. Improved attention to digestive system abnormalities and gastrointestinal symptoms of COVID-19 patients may aid health care providers in the process of clinical diagnosis, treatment, and epidemic prevention and control.

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Hypoalbuminemia on admission in COVID-19 infection: An early predictor of mortality and adverse events. A retrospective observational study

Cited by 44 publications

References 27 publications

The coexistence of low albumin levels and obesity worsens clinical outcomes among subjects admitted for sars-cov-2 infection

The coexistence of low albumin levels and obesity worsens clinical outcomes among subjects admitted for sars-cov-2 infection

Prognostic Value of Glucose-to-Lymphocyte Ratio in Critically Ill Patients with Acute Pancreatitis

COVID-19 and its effects on the digestive system

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