COVID-19 Causes Hypoalbuminemia and Albumin Levels Can be Used as a Biomarker for Disease Severity
Nikhil Prasad Fact checked by:Thailand Medical News Team Mar 22, 2025 1 day, 11 hours, 53 minutes ago
Medical News: The COVID-19 pandemic has unveiled numerous complexities in its pathophysiology, with hypoalbuminemia - low levels of serum albumin - emerging as a significant indicator of disease severity and patient outcomes.
COVID-19 Causes Hypoalbuminemia and Albumin Levels Can be Used as a Biomarker for Disease Severity
Recent studies covered in this
Medical News report, have highlighted that hypoalbuminemia is prevalent among COVID-19 patients and is associated with increased mortality and adverse clinical events.
Understanding Albumin and Its Physiological Role
Albumin, the most abundant protein in human plasma, is synthesized in the liver and serves several critical functions:
-Maintaining Oncotic Pressure: Albumin helps keep fluids within the blood vessels, preventing leakage into tissues.
-Transport Functions: It binds and transports various substances, including hormones, fatty acids, and drugs.
-Antioxidant Properties: Albumin scavenges free radicals, protecting tissues from oxidative damage.
Normal serum albumin levels range from 35 to 50 grams per liter (g/L). Hypoalbuminemia, defined as albumin levels below 35 g/L, can result from factors such as liver disease, kidney dysfunction, malnutrition, or systemic inflammation.
Hypoalbuminemia in COVID-19 Patients
Emerging evidence indicates that hypoalbuminemia is common among COVID-19 patients and correlates with disease severity:
-Prevalence: A retrospective study involving 299 COVID-19 patients found that 35.5% had hypoalbuminemia upon admission.
-Severity Correlation: Patients with hypoalbuminemia were more likely to require intensive care unit (ICU) admission and had higher mortality rates compared to those with normal albumin levels.
-Predictive Value: Hypoalbuminemia on admission has been identified as an early predictor of in-hospital mortality, independent of age, comorbidities, and inflammatory markers.
Mechanisms Leading to Hypoalbuminemia in COVID-19
Several pathophysiological mechanisms may contribute to reduced albumin levels in COVID-19 patients:
Systemic Inflammation:
The cytokine storm associated with severe COVID-19 leads to increased vascular permeability, causing albumin to leak into the interstitial space. Additionally, inflammatory cytokines can suppress albumin synthesis in the liver.
Liver Dysfunction:
Direct viral infection of hepatocytes or an exaggerated immune response can impair liver function, reducing albumin production.
Nutritional Deficiencies:
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Anorexia, gastrointestinal symptoms, and hypermetabolic states in COVID-19 patients can lead to inadequate nutritional intake, further decreasing albumin synthesis.
Renal Losses:
Acute kidney injury, common in severe COVID-19 cases, can result in proteinuria, leading to albumin loss through the urine.
Clinical Implications of Hypoalbuminemia in COVID-19
The presence of hypoalbuminemia in COVID-19 patients has several clinical implications:
-Risk Stratification: Serum albumin levels can serve as a simple and cost-effective biomarker to identify patients at higher risk of severe disease and mortality.
-Monitoring and Management: Regular monitoring of albumin levels may help in early identification of clinical deterioration, allowing timely interventions.
-Therapeutic Considerations: While hypoalbuminemia is associated with poor outcomes, the benefits of albumin supplementation in COVID-19 patients remain uncertain and require further research.
Conclusion
Hypoalbuminemia is a prevalent and significant prognostic marker in COVID-19 patients, reflecting the underlying inflammatory state and potential organ dysfunction. Recognizing and understanding the implications of low serum albumin levels can aid clinicians in risk stratification and management of individuals affected by SARS-CoV-2.
Continued research is essential to elucidate the mechanisms behind hypoalbuminemia in COVID-19 and to determine effective strategies to mitigate its impact on patient outcomes.
References:
https://www.nature.com/articles/s41598-021-89340-y
https://www.ahajournals.org/doi/10.1161/CIRCRESAHA.120.317173
https://onlinelibrary.wiley.com/doi/10.1002/jmv.26003
https://onlinelibrary.wiley.com/doi/10.1002/jmv.27002
https://www.mdpi.com/1422-0067/23/17/10103
https://www.clinicalnutritionespen.com/article/S2405-4577%2821%2900247-3/fulltext
https://www.sciencedirect.com/science/article/pii/S2405457721002473
https://www.elsevier.es/es-revista-medicina-clinica-2-articulo-hypoalbuminemia-on-admission-in-covid-19-S0025775321000324
https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2020.00153/full
https://www.oaepublish.com/articles/2394-5079.2020.43
https://www.tandfonline.com/doi/full/10.2147/IDR.S510245
https://www.jocmr.org/index.php/JOCMR/article/view/4507/0
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