A new biomarker in severe pneumonia associated with coronavirus disease 2019

hypoalbuminemia. A prospective study

Authors

Keywords:

Biomarkers, Pneumonia, Coronavirus, Hypoalbuminemia, Emergency medicine

Abstract

BACKGROUND: Effective triage and early detection are very important for controlling and treating coronavirus disease 2019 (COVID-19). Thus, the relationships between hypoalbuminemia and other acute-phase reactants in such cases need to be evaluated. OBJECTIVES: To investigate the importance of albumin levels in cases of severe pneumonia due to COVID-19. DESIGN AND SETTING: Prospective study conducted in Ankara City Hospital (a stage 3 hospital), Turkey. METHODS: Data from 122 patients diagnosed with pneumonia due to COVID-19 who were admitted to this hospital were analyzed statistically in comparison with date from 60 healthy controls. Three groups were established: healthy controls, intubated patients and non-intubated patients. Lung tomography scans from the patients were examined one-by-one. Real-time polymerase chain reaction (RT-PCR) test results were recorded. RESULTS: Albumin levels were statistically significantly lower in the intubated and non-intubated groups than in the control group, in comparing the three groups (P < 0.01). The other acute-phase reactants, i.e. neutrophil-to-lymphocyte ratio and C-reactive protein levels, were significantly higher in the intubated and non-intubated groups than in the control group (P < 0.05). Albumin levels were also significantly lower in the intubated group than in the non-intubated group (P = 0.02). No differences were detected with regard to other parameters (P > 0.05). CONCLUSIONS: Hypoalbuminemia may constitute a biomarker indicating the severity of pneumonia due to COVID-19.

Downloads

Download data is not yet available.

Author Biographies

Yavuz Otal, Ankara City Hospital

MD. Physician, Department of Emergency Medicine, Ankara City Hospital, Ankara, Turkey.

Gamze Avcıoglu, Ankara City Hospital

MD. Physician, Department of Medical Biochemistry, Karadeniz Ereğli State Hospital, Zonguldak, Turkey.

Fadime Gullu Haydar, Ankara City Hospital

MD. Physician, Department of General Surgery, Ankara City Hospital, Ankara, Turkey.

References

Coronaviridae Study Group of the International Committee on Taxonomy of Viruses. The species severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2. Nat Microbiol. 2020;5(4):536-44. PMID: 32123347; https://doi.org/10.1038/S41564-020-0695-z.

World Health Organization homepage. Available from: https://www.who.int/ Accessed in 2021 (Feb 25).

Bernardi M, Angeli P, Claria J, et al. Albumin in decompensated cirrhosis: new concepts and perspectives. Gut. 2020;69(6):1127-38. PMID: 32102926; https://doi.org/10.1136/gutjnl-2019-318843.

Kalra L, Smith CJ, Hodsoll et al. Elevated C-reactive protein increases diagnostic accuracy of algorithm-defined stroke-associated pneumonia in afebrile patients. Int J Stroke. 2019;14(2):167-73. PMID: 30196790; https://doi.org/10.1177/1747493018798527.

Li W, Ai X, Ni Y, Ye Z, Liang Z. The Association Between the Neutrophil-to-Lymphocyte Ratio and Mortality in Patients with Acute Respiratory Distress Syndrome: A Retrospective Cohort Study. Shock. 2019;51(2):161-7. PMID: 29528904; https://doi.org/10.1097/shk.0000000000001136.

Lu A, Li H, Zheng Y, et al. Prognostic Significance of Neutrophil to Lymphocyte Ratio, Lymphocyte to Monocyte Ratio, and Platelet to Lymphocyte Ratio in Patients with Nasopharyngeal Carcinoma. Biomed Res Int. 2017;2017:3047802. PMID: 28321405; https://doi.org/10.1155/2017/3047802.

Huang J, Cheng A, Kumar R, et al. Hypoalbuminemia predicts the outcome of COVID-19 independent of age and co-morbidity. J Med Virol. 2020;92(10):2152-8. PMID: 32406952; https://doi.org/10.1002/jmv.26003.

Soeters PB, Wolfe RR, Shenkin A. Hypoalbuminemia: Pathogenesis and Clinical Significance. JPEN J Parenter Enteral Nutr. 2019;43(2):181-93. PMID: 30288759; https://doi.org/10.1002/jpen.1451.

Fulks M, Stout RL, Dolan VF. Albumin and all-cause mortality risk in insurance applicants. J Insur Med. 2010;42(1):11-7. PMID: 21290995.

Goldwasser P, Feldman J. Association of serum albumin and mortality risk. J Clin Epidemiol. 1997;50(6):693-703. PMID: 9250267; https://doi.org/10.1016/s0895-4356(97)00015-2.

Liu Y, Yang Y, Zhang C, et al. Clinical and biochemical indexes from 2019-nCoV infected patients linked to viral loads and lung injury. Sci China Life Sci. 2020;63(3):364-74. PMID: 32048163; https://doi.org/10.1007/s11427-020-1643-8.

Bannaga AS, Tabuso M, Farrugia A, et al. C-reactive protein and albumin association with mortality of hospitalised SARS-CoV-2 patients: A tertiary hospital experience. Clin Med (Lond). 2020;20(5):463-7. PMID: 32934038; https://doi.org/10.7861/clinmed.2020-0424.

Afari ME, Bhat T. Neutrophil to lymphocyte ratio (NLR) and cardiovascular diseases: an update. Expert Rev Cardiovasc Ther. 2016;14(5):573-7. PMID: 26878164; https://doi.org/10.1586/14779072.2016.1154788.

Wang L. C-reactive protein levels in the early stage of COVID-19. Med Mal Infect. 2020;50(4):332-4. PMID: 32243911; https://doi.org/10.1016/j.medmal.2020.03.007.

Downloads

Published

2022-05-05

How to Cite

1.
Otal Y, Avcıoglu G, Haydar FG. A new biomarker in severe pneumonia associated with coronavirus disease 2019: hypoalbuminemia. A prospective study. Sao Paulo Med J [Internet]. 2022 May 5 [cited 2025 Mar. 9];140(3):378-83. Available from: https://periodicosapm.emnuvens.com.br/spmj/article/view/951

Issue

Section

Original Article