Hypoalbuminemia - An Indicator of the Severity and Prognosis of COVID-19 Patients: A Multicentre Retrospective Analysis.
Hypoalbuminemia - An Indicator of the Severity and Prognosis of COVID-19 Patients: A Multicentre Retrospective Analysis.
复制标题
低白蛋白血症 - COVID-19 患者严重程度和预后的指标：多中心回顾性分析
DOI：
10.2147/idr.s327090
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发表时间：
2021
影响因子：
3.9
通讯作者：
Fu Y
中科院分区：
文献类型：
--
作者：
Chen C;Zhang Y;Zhao X;Tao M;Yan W;Fu Y
据报道，COVID-19患者出现低白蛋白血症。探索白蛋白降低的影响因素和可能的不良后果，可能会为COVID-19患者的治疗提供一些指导。在这项多中心回顾性研究中，我们收集了中国武汉三家医院确诊为COVID-19患者的人口统计学、合并症、临床症状、并发症、实验室检查、治疗和结局等信息。比较低白蛋白血症患者与白蛋白正常者的各项指标。采用回归模型分析低白蛋白血症患者的各种影响因素及其与临床结局的关系。并比较低白蛋白血症患者肠内营养治疗前后各项实验室指标的变化。共有482例患者入组本研究。53.7%的患者在入院时发生低白蛋白血症。与白蛋白正常的患者相比，低白蛋白血症患者年龄较大，合并糖尿病、发热、呼吸困难和尿钠排泄的比例较高，预后相对较差。低白蛋白血症患者CRP、白细胞、ALT、AST、总胆红素、ALP、GGT、LDH、肌酸激酶、D-二聚体、球蛋白水平较高，淋巴细胞和嗜酸性粒细胞水平较低。重度、老年、厌食、CRP升高和淋巴细胞减少是COVID-19患者白蛋白降低的独立预测因素。此外，白蛋白降低与不良结局相关。纠正血清白蛋白的营养支持治疗可改善患者结局。COVID-19低白蛋白血症患者往往有更严重的临床表现和更多的生化检查异常，这可能导致临床结局较差。营养支持治疗可改善这些患者的临床结局。
Hypoalbuminemia has been reported in COVID-19 patients. Exploring the influencing factors and possible adverse consequences of albumin reduction may provide some guidance for the treatment of COVID-19 patients. In this multicentre retrospective study, we collected information including demographics, comorbidities, clinical symptoms, complications, laboratory tests, treatment, and outcomes of patients diagnosed with COVID-19 from three hospitals in Wuhan, China. We compared the indexes between patients with hypoalbuminemia and normal albumin. Regression model was used to evaluate various influencing factors of patients with hypoalbuminemia and their relationship with clinical outcomes. We also compared the changes of particular laboratory indexes in patients with hypoalbuminemia before and after enteral nutrition therapy. A total of 482 patients were enrolled in the study. About 53.7% patients developed hypoalbuminemia during admission. Patients with hypoalbuminemia were older, had a higher proportion of combined diabetes mellitus, fever, dyspnea, and natriuresis, and had a relatively poorer prognosis than patients with normal albumin. Patients with hypoalbuminemia had higher levels of CRP, leukocytes, ALT, AST, total bilirubin, ALP, GGT, LDH, creatine kinase, D-dimer, globulin, and lower levels of lymphocytes and eosinophils. Severe, older, anorexia, elevated CRP, and decreased lymphocytes were the independent predictors for decreased albumin in COVID-19 patients. In addition, decreased albumin is correlated with adverse outcomes. Nutritional support therapy to correct serum albumin may improve patient outcomes. COVID-19 patients with hypoalbuminemia tend to have more severe clinical manifestations and more abnormal biochemical tests, which may result in poorer clinical outcomes. Nutritional support therapy may improve the clinical outcome of these patients.