Critical Care and Shock

Serum albumin levels as a marker for multi-organ dysfunction syndrome in coronavirus disease 2019 patients: A prospective observational study

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Objective: Coronavirus disease 2019 (COVID-19) causes a severe impact on patients with comorbidities. Most of them are likely to develop multi-organ dysfunction syndrome (MODS). Serum albumin level is a reliable predictor of severe outcomes in COVID-19 patients. Therefore, this study aimed to investigate the association between serum albumin levels and the risk of developing MODS in COVID-19 patients.

Design: A prospective analytical observational study.

Setting: A single tertiary referral hospital in Surabaya, Indonesia.

Patients and participants: We collected 153 patients from May-June 2021 who were confirmed positive for COVID-19 based on the real-time reverse-transcription polymerase chain reaction (RT-PCR) test aged 19-84 years. Seven patients were excluded due to incomplete data. Therefore, 146 patients were eligible participants.

Interventions: Patients underwent the laboratory test during admission. An eight ml of venous blood plasma specimen was taken. The specimen was examined at the Clinical Pathology Laboratory, Diagnostic Center in our hospital using the enzyme-linked immunosorbent assay (ELISA) method.

Measurement and results: Of 146 COVID-19 patients ages ranged from 19-84 years old. Almost 83% of patients have developed MODS, and 31.5% of them were non survived. Serum albumin of COVID-19 patients with MODS and non-survivor were lower than those who had good outcomes (2.95±0.39; 2.82±0.40 vs 3.07±0.40; 3.19±0.47 g/dl). We found a significant difference between serum albumin levels and the incidence of MODS and mortality (p=0.001). In multivariate analysis, low serum albumin <3.5 g/dl had a 15 times higher risk of developing MODS in COVID-19 patients (p=0.011).

Conclusion: Early hospitalization serum albumin level is an excellent marker for predicting the development of MODS in COVID-19 patients. This first step might help physicians choose an appropriate treatment in the future.