Low Albumin Levels Are Associated with Poorer Outcomes in a Case Series of COVID-19 Patients in Spain: A Retrospective Cohort Study
Low Albumin Levels Are Associated with Poorer Outcomes in a Case Series of COVID-19 Patients in Spain: A Retrospective Cohort Study
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DOI：
10.3390/microorganisms8081106
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发表时间：
2020-08-01
期刊：
影响因子：
4.5
通讯作者：
Gonzalez-Freire, Marta
中科院分区：
文献类型：
--
作者：
de la Rica, Roberto;Borges, Marcio;Gonzalez-Freire, Marta
描述西班牙2019冠状病毒病（COVID-19）患者需要住院治疗的临床和流行病学特征的信息有限。在这项观察性研究中，我们的目的是描述重症（非ICU）和危重（ICU）COVID-19患者在住院前分诊时的临床特征和流行病学特征。分析了48例严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）感染阳性患者（27例非ICU患者和21例ICU患者）（平均年龄66岁，[范围33-88岁]; 67%为男性）。各组之间在年龄或性别方面没有差异。首发症状包括发热（100%）、咳嗽（85%）、呼吸困难（76%）、腹泻（42%）和乏力（21%）。ICU患者呼吸困难的发生率高于非ICU患者（95% vs. 61%，p = 0.022）。ICU患者有淋巴细胞减少症和低白蛋白血症。ICU患者的乳酸脱氢酶（LDH）、C反应蛋白（CRP）和降钙素原显著高于非ICU患者（p< 0.001）。低白蛋白水平与预后不良相关，如住院时间长（r =-0.472，p = 0.001）和死亡率（r =-0.424，p = 0.003）。截至2020年4月28日，10名患者（8名ICU患者和2名非ICU患者）死亡（死亡率为21%），尽管100%的非ICU患者已出院，但33%的ICU患者仍在住院（5名在ICU，2名已转入病房）。患有COVID-19的重症患者会出现淋巴细胞减少症、低白蛋白血症和高水平炎症。
There is limited information available describing the clinical and epidemiological features of Spanish patients requiring hospitalization for coronavirus disease 2019 (COVID-19). In this observational study, we aimed to describe the clinical characteristics and epidemiological features of severe (non-ICU) and critically patients (ICU) with COVID-19 at triage, prior to hospitalization. Forty-eight patients (27 non-ICU and 21 ICU) with positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection were analyzed (mean age, 66 years, [range, 33-88 years]; 67% males). There were no differences in age or sex among groups. Initial symptoms included fever (100%), coughing (85%), dyspnea (76%), diarrhea (42%) and asthenia (21%). ICU patients had a higher prevalence of dyspnea compared to non-ICU patients (95% vs. 61%,p= 0.022). ICU-patients had lymphopenia as well as hypoalbuminemia. Lactate dehydrogenase (LDH), C-reactive protein (CRP), and procalcitonin were significantly higher in ICU patients compared to non-ICU (p< 0.001). Lower albumin levels were associated with poor prognosis measured as longer hospital length (r = -0.472,p< 0.001) and mortality (r = -0.424,p= 0.003). As of 28 April 2020, 10 patients (8 ICU and 2 non-ICU) have died (21% mortality), and while 100% of the non-ICU patients have been discharged, 33% of the ICU patients still remained hospitalized (5 in ICU and 2 had been transferred to ward). Critically ill patients with COVID-19 present lymphopenia, hypoalbuminemia and high levels of inflammation.