Albumin supplementation dampens hypercoagulability in COVID-19. A preliminary report

Coronavirus disease 2019 (COVID-19) is characterized by severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) needing mechanical ventilation and intensive care unit (ICU) treatment. In addition to lung disease, clinical features of SARS-CoV-2 include myocardial damage and ischemia-related vascular disease, which are associated with a hypercoagulable state (e.g., high D-dimer levels) predisposing to thrombotic-related complications and eventually death.1–3 Serum albumin levels <3.5 g/dL are detectable in SARS-CoV-2 patients and associated with death4 and elevated D-dimer and thrombotic events,5 which is in accordance with previous studies reporting an association between serum albumin <3.5 g/dL and risk of venous and arterial thrombosis.6 Thus, we tested the hypothesis that albumin supplementation could dampen hypercoagulability in SARS-CoV-2 with serum albumin <3.5 g/dL. This is an observational cohort study performed at a large university hospital located in Rome and Chieti (Italy) and devoted to COVID-19 care.