Is albumin predictor of mortality in COVID-19

Coronavirus 2019 (Covid-19) is a pandemic associated with a high risk of mortality. Human serum albumin (HSA) is an acute phase reactant with antioxidant property, however its behavior and impact on survival in Covid-19 patients has never been studied so far. Among 319 Covid-19 patients followed-up for a median of 19 days, 64 died. Compared to survivors, non-survivors had more prevalence of Intensive care unit (ICU) admission, chronic obstructive pulmonary disease (COPD), heart failure, elevated levels of D-dimer, hs-CRP and troponins and lower values of albumin. At the Cox regression analysis, albumin (HR: 0.38, 95% CI: 0.23-0.63, p<0.001) and age (HR: 1.03, 95% CI: 1.01-1.06, p=0.001) were independently associated with mortality, irrespective of adjustment for sex, ICU admission, heart failure, COPD and hs-CRP levels. Our observation leads to the hypothesis that HSA analysis may be used to identify patients at higher risk of death in Covid-19 patients.