The impact of hypoalbuminemia and its correlation with D-dimer and IL-6 on severity and 14-day mortality in COVID-19 patients

Background & Objective: COVID-19 took the world by storm, but it also allowed the healthcare professionals to conduct big studies regarding various molecular and biochemical changes produced by the disease. We analyzed the impact of hypoalbuminemia on the severity and 14-day mortality in COVID-19 patients. Methodology: It was an analytical observational, prospective cohort study design. Clinical and laboratory data collection was carried out in the COVID-19 isolation room of Dr. Soetomo Hospital, between July and October 2020. Serum albumin, D-dimer, and interleukin 6 (IL-6) levels were measured on the day of admission. Statistical analysis using Kolmogorov-Smirnov, Mann-Whitney test, regression test, ROC curve, and 14-day risk of mortality were tested using Univariate Cox Regression and Multivariate Cox Regression tests. The Kaplan Meier test was used to analyze life expectancy. Results: Of the 119 study subjects, 71 (59.7%) were categorized as severe, and 48 (40.3%) as not severe. Out of the total, 36 (30.25%) patients expired within 14 days of admission, and 83 (69.75%) survived. Regression analysis showed the effect of age on albumin (P < 0.001), albumin on D-dimer (P = 0.003), albumin on disease severity (P < 0.001), and albumin on 14-day mortality (P < 0.001). Albumin was not significantly associated with IL-6 (P = 0.126). The value of albumin as a predictor of severity was 3.28 g/dL, with a sensitivity of 74.6% and a specificity of 77.1%. Conclusion: The state of hypoalbuminemia affects the disease severity and mortality of COVID-19; albumin is significantly associated with D-dimer. Poor prognosis is expected if the albumin value < 3.28 in geriatric and obese patients with a high 14-days mortality.