1. Ally in Fighting Covid-19: Magnitude of Albumin Decline and Lymphopenia (Ally) Predict Progression to Critical Disease
- Author
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Shelley A. Hall, Joost Felius, Christina Jack, Amit Alam, Ronnie M. Youssef, Johanna S. van Zyl, Robert L. Gottlieb, Aayla K. Jamil, Göran B Klintmalm, Dipesh Bhakta, and Cedric W
- Subjects
Male ,Time Factors ,Disease ,030204 cardiovascular system & hematology ,Logistic regression ,Severity of Illness Index ,0302 clinical medicine ,Risk Factors ,Pandemic ,030212 general & internal medicine ,Letter to the Editor ,Original Research ,risk ,biology ,Medical record ,General Medicine ,Middle Aged ,Texas ,respiratory distress syndrome ,Disease Progression ,Female ,Adult ,medicine.medical_specialty ,Critical Illness ,serum albumin ,Serum albumin ,Serum Albumin, Human ,Models, Biological ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,Lymphopenia ,Internal medicine ,Severity of illness ,medicine ,pneumonia ,Humans ,Pandemics ,Aged ,SARS ,SARS-CoV-2 ,business.industry ,Albumin ,COVID-19 ,medicine.disease ,critical care ,Pneumonia ,inflammation ,biology.protein ,business - Abstract
The global severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic leading to coronavirus disease 2019 (COVID-19) is straining hospitals. Judicious resource allocation is paramount but difficult due to the unpredictable disease course. Once hospitalized, discerning which patients may progress to critical disease would be valuable for resource planning. Medical records were reviewed for consecutive hospitalized patients with COVID-19 in a large healthcare system in Texas. The main outcome was progression to critical disease within 10 days from admission. Albumin trends from admission to 7 days were analyzed using mixed-effects models, and progression to critical disease was modeled by multivariable logistic regression of laboratory results. Risk models were evaluated in an independent group. Of 153 non-critical patients, 28 (18%) progressed to critical disease. The rate of decrease in mean baseline-corrected (Δ) albumin was −0.08 g/dL/day (95% CI −0.11 to −0.04; p70% of hospitalized cases that progressed to critical COVID-19 disease. We recommend prospectively tracking albumin. This is a globally applicable tool for all healthcare systems.
- Published
- 2021
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