The Impact of Hypoalbuminemia on Inflammatory Markers, Serum Creatinine, Hemoglobin and Outcome in Critically ill Patients With COVID-19 Infection-Retrospective Observation Study.

Background: Hypoalbuminemia is a poor clinical indicator of mortality. However, data on the correlation between hypoalbuminemia and inflammatory markers in COVID-19 infections are scarce.

Objective: The study aims to investigate the effects of hypoalbuminemia on inflammatory markers, serum creatinine, hemoglobin levels, and clinical outcomes in critically ill COVID-19 patients.

Methods: A retrospective review of all adult patients admitted to the intensive care unit (ICU) in King Fahd University Hospital with a moderate to severe COVID-19 infection from January 2020 to August 2022 was performed. The value of serum albumin levels was obtained on the day of admission while, the serum ferritin, lactate dehydrogenase (LDH), C-reactive protein (CRP), creatinine, and hemoglobin levels on the first and third days of ICU admission. Demographic data, oxygen support modality, ICU length of stay (ICU-LOS), renal replacement therapy (RRT), and deaths were collected.

Results: Of 420 patients, 255 were included, 131 (51.4%) of whom had hypoalbuminemia. The numbers of patients with hypoalbuminemia who had increases in ferritin, CRP, and LDH between the first and third days of admission were 65 (49.6%), 9 (6.9%), and 10 (7.6%), respectively. In contrast, to the cohort with normal albumin levels, increases in ferritin, CRP, and LDH were noted in 57 (46%), 7 (5.6%), and 14 (11.3%) patients, respectively. The decrease in hemoglobin levels was similar between both groups (p=0.1). No significant association was found between hypoalbuminemia and increases in serum creatinine, the requirement of RRT, the need for endotracheal intubation, and mortality.

Conclusion: This study did not show a significant correlation between hypoalbuminemia and worsening inflammatory markers or clinical outcomes in critically ill COVID-19 patients.