cd0dd3998a5609573d2a75445e921294 pmc_34768653.pdf e51027d0006a9156e6f442f73a0ddcb2805219f7 pmc_34768653.pdf f14e53c7377e7e24f90fe99d2d940676983753abad47e06ea19caa41d6e166fa pmc_34768653.pdf Title: Severe Hypoalbuminemia at Admission Is Strongly Associated with Worse Prognosis in Older Adults with SARS-CoV-2 Infection Subject: Serum albumin levels have been associated with prognosis in several conditions among older adults. The aim of this study is to assess the prognostic value in mortality of serum albumin in older adults with SARS-CoV-2 infection. Methods. Cohort observational study with consecutive older-adults (65 years old), with confirmed SARS-CoV-2 infection admitted to a university hospital between March–May 2020. A logistic regression model was fitted to assess the impact of albumin levels on in-hospital mortality adjusted by potential confounders. Results. Among a total of 840 patients admitted to the hospital, 405 (48%) were older adults with a total of 92 deaths (23%) among them. Those who died were older, had more comorbidities, higher inflammation status and lower levels of serum albumin at admission [3.10 g/dL (0.51) vs. 3.45 g/dL (0.45); p < 0.01. Serum albumin levels at admission were negatively correlated with inflammatory markers such as C-Reactive protein (Pearson Coeff -0.4634; p < 0.001) or IL-6 (Pearson’s Coeff -0.244; p = 0.006) at admission but also to other clinical outcomes such time to clinical stability (Pearson’s Coeff -0.259; p < 0.001). Severe hypoalbuminemia associated with increased risk of mortality was defined as 3 g/dL at admission according to the AUC/ROC analysis (0.72 95% CI 0.63–0.81) In a multivariate logistic regression model adjusting by age, inflammation, comorbidities and severity at admission severe hypoalbuminemia was a strong predictor of in-hospital mortality (OR 2.18 95% CI 1.03–4.62; p = 0.039). Conclusion. Severe hypoalbuminemia with 3 g/dL is an independent risk factor for mortality among older adults with SARS-CoV-2 infection. There is a consistent correlation between albumin levels and inflammatory biomarkers. Further studies are needed to determine whether the supplementation of albumin as coadjuvant treatment will have a positive impact on the prognosis of this infection. Keywords: SARS-CoV-2; older adults; albumina; outcomes Author: Isabel Arnau-Barrés, Ana Pascual-Dapena, Inmaculada López-Montesinos, Silvia Gómez-Zorrilla, Luisa Sorlí, Marta Herrero, Xavier Nogués, Claudia Navarro-Valls, Beatriz Ibarra, Lizzeth Canchucaja, Elizabeth da Costa Venancio, Fabiola Blasco-Hernando, Juany Cruz, Olga Vázquez, Ramón Miralles, Natalia García-Giralt and Robert Güerri-Fernández Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Sun Oct 31 13:48:04 2021 CET ModDate: Sun Oct 31 14:07:14 2021 CET Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 9 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 596115 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- DRZUJM+VnURWPalladioL Type 1 Custom yes yes no 10 0 WXXZEK+URWPalladioL-Ital Type 1 Custom yes yes no 15 0 IAFPME+URWPalladioL-Bold Type 1 Custom yes yes no 20 0 YKKQWT+URWPalladioL-Roma Type 1 Custom yes yes no 24 0 RQPVQI+CMSY10 Type 1 Builtin yes yes no 28 0 JYPLJJ+VnURWPalladioL-Bold Type 1 Custom yes yes no 32 0 XPUSBJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 40 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 43 0 MCBCCI+SourceSansRoman-Regular Type 1C Custom yes yes no 65 0 MCBCCM+SourceSansRoman.613wght Type 1C Custom yes yes no 69 0 MCBCCO+SourceSansRoman-Bold Type 1C Custom yes yes no 73 0 JLZORU+EURM10 Type 1 Builtin yes yes no 88 0 QLBIEB+URWPalladioL-BoldItal Type 1 Custom yes yes no 96 0 BCDEEE+PalatinoLinotype-Bold TrueType WinAnsi yes yes no 104 0 BCDFEE+PalatinoLinotype-Roman TrueType WinAnsi yes yes no 108 0 BCDGEE+PalatinoLinotype-Italic TrueType WinAnsi yes yes no 112 0 BCDHEE+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 116 0 BCDIEE+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 123 0 SymbolMT CID TrueType Identity-H yes no yes 130 0 BCDKEE+PalatinoLinotype-BoldItalic TrueType WinAnsi yes yes no 138 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2022-03-22 02:36:27 CET RepresentationInformation: pmc_34768653.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2022-01-11 05:14:38 CET Size: 596115 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 280 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7b69c6ba Item: Title: Patients and Methods Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@46daef40 Children: Item: Title: Ethics Considerations Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@12f41634 Item: Title: Statistical Analysis Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@13c27452 Item: Title: Results Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@262b2c86 Children: Item: Title: Subsection Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@371a67ec Children: Item: Title: Older Adults with and without Severe Hypoalbuminemia Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@5ed828d Item: Title: Correlation of Albumin and Clinical Markers Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@50d0686 Item: Title: Discussion Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7a3d45bd Item: Title: Conclusions Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1e7c7811 Item: Title: References Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77ec78b9 Info: Title: Severe Hypoalbuminemia at Admission Is Strongly Associated with Worse Prognosis in Older Adults with SARS-CoV-2 Infection Author: Isabel Arnau-Barrés, Ana Pascual-Dapena, Inmaculada López-Montesinos, Silvia Gómez-Zorrilla, Luisa Sorlí, Marta Herrero, Xavier Nogués, Claudia Navarro-Valls, Beatriz Ibarra, Lizzeth Canchucaja, Elizabeth da Costa Venancio, Fabiola Blasco-Hernando, Juany Cruz, Olga Vázquez, Ramón Miralles, Natalia García-Giralt and Robert Güerri-Fernández Subject: Serum albumin levels have been associated with prognosis in several conditions among older adults. The aim of this study is to assess the prognostic value in mortality of serum albumin in older adults with SARS-CoV-2 infection. Methods. Cohort observational study with consecutive older-adults (65 years old), with confirmed SARS-CoV-2 infection admitted to a university hospital between March May 2020. A logistic regression model was fitted to assess the impact of albumin levels on in-hospital mortality adjusted by potential confounders. Results. Among a total of 840 patients admitted to the hospital, 405 (48%) were older adults with a total of 92 deaths (23%) among them. Those who died were older, had more comorbidities, higher inflammation status and lower levels of serum albumin at admission [3.10 g/dL (0.51) vs. 3.45 g/dL (0.45); p < 0.01. Serum albumin levels at admission were negatively correlated with inflammatory markers such as C-Reactive protein (Pearson Coeff -0.4634; p < 0.001) or IL-6 (Pearson’s Coeff -0.244; p = 0.006) at admission but also to other clinical outcomes such time to clinical stability (Pearson’s Coeff -0.259; p < 0.001). Severe hypoalbuminemia associated with increased risk of mortality was defined as 3 g/dL at admission according to the AUC/ROC analysis (0.72 95% CI 0.63 0.81) In a multivariate logistic regression model adjusting by age, inflammation, comorbidities and severity at admission severe hypoalbuminemia was a strong predictor of in-hospital mortality (OR 2.18 95% CI 1.03 4.62; p = 0.039). Conclusion. Severe hypoalbuminemia with 3 g/dL is an independent risk factor for mortality among older adults with SARS-CoV-2 infection. There is a consistent correlation between albumin levels and inflammatory biomarkers. Further studies are needed to determine whether the supplementation of albumin as coadjuvant treatment will have a positive impact on the prognosis of this infection. 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