Association of Serum Albumin and Lipoproteins as strong predictor of severity in patients with COVID-19

Abstract

Coronavirus disease 2019 (COVID-19) has been proclaimed to be one of the deadliest and most infectiouspandemic of the modern times which is caused by the SARS-CoV-2 (severe acute respiratory syndrome corona virus 2). The aim of this study was to establish an association, if any, between serum albumin and serum lipoproteins (mainly HDL and LDL) and COVID-19 severity and adverse outcomes. In this study, we extracted data from 500 clinically confirmed and hospitalized COVID-19 patients (>= 18 years of age) between June 2020 to February 2021 at the associated hospital of Rajarshi Dashrath Autonomous State Medical College (RDASMC), Ayodhya, Uttar Pradesh, India. The patients were divided into two groups- mild to moderate and severe groups according to the Centers for Disease Control and Prevention (CDC). Serum albumin, Serum globulin, A/G ratio, high density lipoproteins (HDL) and lowdensity lipoprotein (LDL) concentrations were measured and compared amongst these groups. The median age of these 500 patients was 59 years (IQR: 47-66). Out of the total 500 patients hospitalized and enrolled in this study, 79.7% (n= 398) were mild to moderately affected while 20.3% (n=102) were severely affected. Significant hypoalbuminemia was observed in 53.3% and 83.5% in mild to moderate and severely affected groups respectively. We also found out a significantly low concentrations of serum LDL and HDL levels in severely affected group as compared to the mild to moderately affected group.Thus, with severity of disease, a drastic reduction in serum albumin as well as serum LDL and HDL levels is indicative of a possible hepatotoxicity that may exacerbate survival chances in severely affected patients.