Article ; Online: Decreased serum albumin level indicates poor prognosis of COVID-19 patients: hepatic injury analysis from 2,623 hospitalized cases.
2020 Volume 63, Issue 11, Page(s) 1678–1687
Abstract: ... of COVID-19 patients. In this retrospective study, we extracted data from 2,623 clinically confirmed adult ... in accordance with the Chinese Clinical Guideline for COVID-19. Serum albumin ... cytokines levels were measured and compared among these three groups. The median age of these 2,623 patients ...
| Abstract | Coronavirus disease 2019 (COVID-19) is a global pandemic which has caused numerous deaths worldwide. The present study investigated the roles of hypoproteinemia in the clinical outcome and liver dysfunction of COVID-19 patients. In this retrospective study, we extracted data from 2,623 clinically confirmed adult COVID-19 patients (>18 years old) between January 29, 2020 and March 6, 2020 in Tongji Hospital, Wuhan, China. The patients were divided into three groups-non-critically ill, critically ill, and death groups-in accordance with the Chinese Clinical Guideline for COVID-19. Serum albumin, low-density lipoproteins cholesterol (LDL-C), and high-density lipoproteins cholesterol (HDL-C) concentrations and inflammatory cytokines levels were measured and compared among these three groups. The median age of these 2,623 patients was 64 years old (interquartile range (IQR), 52-71). Among the patients enrolled in the study, 2,008 (76.6%) were diagnosed as non-critically ill and 615 (23.4%) were critically ill patients, including 383 (14.6%) critically ill survivors and 232 (8.8%) critically ill deaths in the hospital. Marked hypoalbuminemia occurred in 38.2%, 71.2%, and 82.4% patients in non-critically ill, critically ill, and death groups, respectively, on admission and 45.9%, 77.7%, and 95.6% of these three groups, respectively, during hospitalization. We also discovered that serum low-density lipoprotein (LDL) and HDL levels were significantly lower in critically ill and death groups compared to non-critically ill group. Meanwhile, the patients displayed dramatically elevated levels of serum inflammatory factors, while a markedly prolonged activated partial thromboplastin time (APTT) in critically ill patients reflected coagulopathy. This study suggests that COVID-19-induced cytokine storm causes hepatotoxicity and subsequently critical hypoalbuminemia, which are associated with exacerbation of disease-associated inflammatory responses and progression of the disease and ultimately leads to death for some critically ill patients. |
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| MeSH term(s) | Aged ; COVID-19/blood ; COVID-19/complications ; COVID-19/mortality ; China ; Cholesterol, HDL/blood ; Cholesterol, LDL/blood ; Coronavirus Infections/blood ; Coronavirus Infections/complications ; Coronavirus Infections/mortality ; Critical Illness ; Cytokines/blood ; Female ; Humans ; Liver Diseases/blood ; Liver Diseases/etiology ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Risk Factors ; SARS-CoV-2 ; Serum Albumin, Human/metabolism ; Thromboplastin/metabolism ; Time Factors |
| Chemical Substances | Cholesterol, HDL ; Cholesterol, LDL ; Cytokines ; Thromboplastin (9035-58-9) ; Serum Albumin, Human (ZIF514RVZR) |
| Keywords | covid19 |
| Language | English |
| Publishing date | 2020-06-18 |
| Publishing country | China |
| Document type | Journal Article |
| ZDB-ID | 2546732-3 |
| ISSN | 1869-1889 ; 1674-7305 |
| ISSN (online) | 1869-1889 |
| ISSN | 1674-7305 |
| DOI | 10.1007/s11427-020-1733-4 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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