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Correlation of Plasma Albumin Status with Markers of Hepato-biliary Dysfunction and Systemic Inflammation Among COVID-19 Patients

Received: 26 January 2022    Accepted: 10 February 2022    Published: 9 March 2022
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Abstract

Background: Several studies have reported profound altered serum albumin level status among patients with COVID-19 disease. Hence, the current study aimed to evaluate the plasma albumin status levels and to establish the relationship between serum albumin level status and markers of hepato-biliary dysfunction and systemic inflammation among COVID-19 patients of African origin. Methods: This was a retrospective study of pre-treatment data obtained from patients with confirmed real-time reverse transcription-polymerase chain reaction COVID-19 disease in Eleme COVID-19 treatment center, Port Harcourt, Southern Nigeria. Data were obtained from each patients’ case notes, medical review charts, nurses’ vital signs/medication charts, laboratory records, and archived data from the electronic medical records using trained research assistants at the treatment center. The data extraction was done using validated data collection templates. Data analysis was done using standard protocols. Results: Among the 473 studied cases, 112 (23.7%) had normal plasma albumin status while 361 (76.3%) had low plasma albumin status. Among the low plasma albumin status subgroups, 57.6% and 42.4% had clinically insignificant and clinically significant low plasma albumin status levels, respectively. No difference was observed in the mean plasma levels/activities of all the markers of hepato-biliary dysfunctions between the subjects with normal and low albumin status levels and also between the clinically insignificant and clinically significant low plasma albumin status subgroups (p>0.05). However, a statistically significant difference was observed in the mean plasma levels of all the systemic inflammatory markers between the subjects with normal and low albumin status levels as well as between the clinically insignificant and clinically significant low plasma albumin status subgroups (p<0.05). Furthermore, no statistically significant relationship existed between the plasma albumin status levels and all the markers of hepato-biliary dysfunctions (p>0.05). However, significant inverse relationships existed between plasma albumin status levels and all the systemic inflammatory markers/indices (p<0.05). Conclusion: The present study indicates that low plasma albumin level status is common among COVID-19 patients and correlates significantly with systemic inflammation. Since COVID-19 is invariably associated with systemic inflammation, albumin may have therapeutic value in COVID-19 management. However, further studies are highly recommended.

Published in Biomedical Sciences (Volume 8, Issue 1)
DOI 10.11648/j.bs.20220801.17
Page(s) 41-48
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

COVID-19, Low Albumin Status, Hepato-biliary Dysfunction, Inflammation

References
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[2] Samaddar A, Grover M, Nag VL. Pathophysiology and Potential Therapeutic Candidates for COVID-19: A Poorly Understood Arena. Front Pharmacol. 2020; 11: 585888. DOI: 10.3389/fphar.2020.585888.
[3] Yuki K, Fujiogi M, Koutsogiannaki S. COVID-19 pathophysiology: A review. Clin Immunol. 2020; 215: 108427. DOI: 10.1016/j.clim.2020.108427.
[4] Evik M, Kuppalli K, Kindrachuk J, Peiris M. Virology, transmission, and pathogenesis of SARS-CoV-2. BMJ. 2020; 371: m3862. DOI: 10.1136/bmj.m3862.
[5] Chen C, Zhang Y, Zhao X, Tao M, Yan W, Fu Y. Hypoalbuminemia - An Indicator of the Severity and Prognosis of COVID-19 Patients: A Multicentre Retrospective Analysis. Infect Drug Resist. 2021; 14: 3699-3710. DOI: 10.2147/IDR.S327090.
[6] Huang J, Cheng A, Kumar R, Fang Y, Chen G, Zhu Y, Lin S. Hypoalbuminemia predicts the outcome of COVID‐19 independent of age and co‐morbidity. J Med virol. 2020; 92 (10): 2152-8.
[7] Ramadori G. Hypoalbuminemia: an underestimated, vital characteristic of hospitalized COVID-19 positive patients?. Hepatoma Research. 2020; 6: 28. DOI: 10.20517/2394-5079.2020.43.
[8] Viana-Llamas MC, Arroyo-Espliguero R, Silva-Obregón JA, Uribe-Heredia G, Núñez-Gil I, García-Magallón B, et al. Hypoalbuminemia on admission in COVID-19 infection: An early predictor of mortality and adverse events. A retrospective observational study. Med Clin (Barc). 2021; 156 (9): 428-436. DOI: 10.1016/j.medcli.2020.12.018.
[9] Arnau-Barrés I, Pascual-Dapena A, López-Montesinos I, Gómez-Zorrilla S, Sorlí L, Herrero M, et al. Severe Hypoalbuminemia at Admission Is Strongly Associated with Worse Prognosis in Older Adults with SARS-CoV-2 Infection. J Clin Med. 2021 Oct 31; 10 (21): 5134. DOI: 10.3390/jcm10215134.
[10] Musa S. Hepatic and gastrointestinal involvement in coronavirus disease 2019 (COVID-19): What do we know till now?. Arab J Gastroenterol. 2020; 21 (1): 3-8. DOI: 10.1016/j.ajg.2020.03.002.
[11] Nigerian Centre for Disease Control (NCDC) National Interim Guidelines for Clinical Management of COVID-19. Accessed 26th January 2022.
[12] Kuluöztürk M, Deveci F, Turgut T, Öner Ö. The Glasgow Prognostic Score and fibrinogen to albumin ratio as prognostic factors in hospitalized patients with COVID-19. Expert Rev Respir Med. 2021; 15 (8): 1061-106 DOI: 10.1080/17476348.2021.1923483.
[13] Amadi C, Amadi B. Hypoalbuminemia Predicts Poor Pregnancy Outcome among Cases of HELLP Syndrome in Nigeria. Int J Health Sci Res. 2021; 11 (11): 252-60.
[14] Rabbani G, Ahn SN. Review: Roles of human serum albumin in prediction, diagnoses and treatment of COVID-19. Int J Biol Macromol. 2021; 193 (Pt A): 948-955. DOI: 10.1016/j.ijbiomac.2021.10.095.
[15] Soeters PB, Wolfe RR, Shenkin A. Hypoalbuminemia: pathogenesis and clinical significance. JPEN J Parenter Enteral Nutr. 2019; 43: 181–93.
[16] Huang W, Li C, Wang Z, Wang H, Zhou N, Jiang J, et al. Ni L, Decreased serum albumin level indicates poor prognosis of COVID-19 patients: hepatic injury analysis from 2,623 hospitalized cases. Sci China Life Sci. 2020; 63 (11): 1678-87. DOI: 10.1007/s11427-020-1733-4.
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  • APA Style

    Collins Amadi, Stephenson Lawson, Bright Amadi, Ezra Agbo. (2022). Correlation of Plasma Albumin Status with Markers of Hepato-biliary Dysfunction and Systemic Inflammation Among COVID-19 Patients. Biomedical Sciences, 8(1), 41-48. https://doi.org/10.11648/j.bs.20220801.17

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    ACS Style

    Collins Amadi; Stephenson Lawson; Bright Amadi; Ezra Agbo. Correlation of Plasma Albumin Status with Markers of Hepato-biliary Dysfunction and Systemic Inflammation Among COVID-19 Patients. Biomed. Sci. 2022, 8(1), 41-48. doi: 10.11648/j.bs.20220801.17

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    AMA Style

    Collins Amadi, Stephenson Lawson, Bright Amadi, Ezra Agbo. Correlation of Plasma Albumin Status with Markers of Hepato-biliary Dysfunction and Systemic Inflammation Among COVID-19 Patients. Biomed Sci. 2022;8(1):41-48. doi: 10.11648/j.bs.20220801.17

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  • @article{10.11648/j.bs.20220801.17,
      author = {Collins Amadi and Stephenson Lawson and Bright Amadi and Ezra Agbo},
      title = {Correlation of Plasma Albumin Status with Markers of Hepato-biliary Dysfunction and Systemic Inflammation Among COVID-19 Patients},
      journal = {Biomedical Sciences},
      volume = {8},
      number = {1},
      pages = {41-48},
      doi = {10.11648/j.bs.20220801.17},
      url = {https://doi.org/10.11648/j.bs.20220801.17},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.bs.20220801.17},
      abstract = {Background: Several studies have reported profound altered serum albumin level status among patients with COVID-19 disease. Hence, the current study aimed to evaluate the plasma albumin status levels and to establish the relationship between serum albumin level status and markers of hepato-biliary dysfunction and systemic inflammation among COVID-19 patients of African origin. Methods: This was a retrospective study of pre-treatment data obtained from patients with confirmed real-time reverse transcription-polymerase chain reaction COVID-19 disease in Eleme COVID-19 treatment center, Port Harcourt, Southern Nigeria. Data were obtained from each patients’ case notes, medical review charts, nurses’ vital signs/medication charts, laboratory records, and archived data from the electronic medical records using trained research assistants at the treatment center. The data extraction was done using validated data collection templates. Data analysis was done using standard protocols. Results: Among the 473 studied cases, 112 (23.7%) had normal plasma albumin status while 361 (76.3%) had low plasma albumin status. Among the low plasma albumin status subgroups, 57.6% and 42.4% had clinically insignificant and clinically significant low plasma albumin status levels, respectively. No difference was observed in the mean plasma levels/activities of all the markers of hepato-biliary dysfunctions between the subjects with normal and low albumin status levels and also between the clinically insignificant and clinically significant low plasma albumin status subgroups (p>0.05). However, a statistically significant difference was observed in the mean plasma levels of all the systemic inflammatory markers between the subjects with normal and low albumin status levels as well as between the clinically insignificant and clinically significant low plasma albumin status subgroups (p0.05). However, significant inverse relationships existed between plasma albumin status levels and all the systemic inflammatory markers/indices (pConclusion: The present study indicates that low plasma albumin level status is common among COVID-19 patients and correlates significantly with systemic inflammation. Since COVID-19 is invariably associated with systemic inflammation, albumin may have therapeutic value in COVID-19 management. However, further studies are highly recommended.},
     year = {2022}
    }
    

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  • TY  - JOUR
    T1  - Correlation of Plasma Albumin Status with Markers of Hepato-biliary Dysfunction and Systemic Inflammation Among COVID-19 Patients
    AU  - Collins Amadi
    AU  - Stephenson Lawson
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    AB  - Background: Several studies have reported profound altered serum albumin level status among patients with COVID-19 disease. Hence, the current study aimed to evaluate the plasma albumin status levels and to establish the relationship between serum albumin level status and markers of hepato-biliary dysfunction and systemic inflammation among COVID-19 patients of African origin. Methods: This was a retrospective study of pre-treatment data obtained from patients with confirmed real-time reverse transcription-polymerase chain reaction COVID-19 disease in Eleme COVID-19 treatment center, Port Harcourt, Southern Nigeria. Data were obtained from each patients’ case notes, medical review charts, nurses’ vital signs/medication charts, laboratory records, and archived data from the electronic medical records using trained research assistants at the treatment center. The data extraction was done using validated data collection templates. Data analysis was done using standard protocols. Results: Among the 473 studied cases, 112 (23.7%) had normal plasma albumin status while 361 (76.3%) had low plasma albumin status. Among the low plasma albumin status subgroups, 57.6% and 42.4% had clinically insignificant and clinically significant low plasma albumin status levels, respectively. No difference was observed in the mean plasma levels/activities of all the markers of hepato-biliary dysfunctions between the subjects with normal and low albumin status levels and also between the clinically insignificant and clinically significant low plasma albumin status subgroups (p>0.05). However, a statistically significant difference was observed in the mean plasma levels of all the systemic inflammatory markers between the subjects with normal and low albumin status levels as well as between the clinically insignificant and clinically significant low plasma albumin status subgroups (p0.05). However, significant inverse relationships existed between plasma albumin status levels and all the systemic inflammatory markers/indices (pConclusion: The present study indicates that low plasma albumin level status is common among COVID-19 patients and correlates significantly with systemic inflammation. Since COVID-19 is invariably associated with systemic inflammation, albumin may have therapeutic value in COVID-19 management. However, further studies are highly recommended.
    VL  - 8
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Author Information
  • Department of Chemical Pathology, Rivers State University/Rivers State University Teaching Hospital, Port Harcourt, Nigeria; Department of Chemical Pathology, PAMO University of Medical Sciences, Port Harcourt, Nigeria

  • Department of Medical Microbiology/Parasitology, Rivers State University/Rivers State University Teaching Hospital, Port Harcourt, Nigeria;Department of Medical Microbiology/Parasitology, PAMO University of Medical Sciences, Port Harcourt, Nigeria; COVID-19 Treatment Center, Eleme, Port Harcourt, Nigeria

  • Department of Chemical Pathology, Rivers State University/Rivers State University Teaching Hospital, Port Harcourt, Nigeria

  • Department of Chemical Pathology, Federal Medical Centre, Owerri, Nigeria

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