Impact of Albumin Therapy in Critically Ill COVID-19 Patients: A Retrospective Cohort Study
Published: April 1, 2024 | DOI: https://doi.org/10.7860/JCDR/2024/68774.19236
Bonchanpalli Mohan Kumar, Mustahsin Malik, Rajesh Kumar
1. Junior Resident, Department of Critical Care Unit and Anaesthesiology, Era’s Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India.
2. Professor, Department of Critical Care Unit and Anaesthesiology, Era’s Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India.
3. Assistant Professor, Department of Critical Care Unit and Anaesthesiology, Era’s Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India.
Correspondence
Dr. Rajesh Kumar,
Department of Anaesthesiology, Era’s Lucknow Medical University and Hospital, Lucknow-226003, Uttar Pradesh, India.
E-mail: docraj198810@gmail.com
Introduction: Coronavirus Disease 2019 (COVID-19) is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Due to the limited understanding of this disease, research has quickly extended towards identifying biomarkers to predict its prognosis and progression.
Aim: To explore the impact of albumin infusion on critically ill COVID-19 patients.
Materials and Methods: In this retrospective cohort study, a total of 150 severe COVID-19 patients aged 18 to 65 years were enrolled. These patients were categorised into the no albumin infusion group (n=61), consisting of those who did not undergo albumin transfusion during their treatment, and the albumin infusion group (n=89), comprising patients who received albumin transfusion as part of their treatment protocol. Assessments of hospitalisation included the Sequential Organ Failure Assessment (SOFA), and Acute Physiology and Chronic Health Evaluation (APACHE-II) scores obtained at baseline and day 5. Unpaired t-tests, Chi-square tests, and paired t-tests were used for analysis.
Results: The mean values of Haemoglobin (Hb), eosinophils, Random Blood Sugar (RBS), Mean Corpuscular Volume (MCV), total protein, serum urea, serum bilirubin, Prothrombin Time (PT), International Normalised Ratio (INR), Interleukin 6 (IL-6), Erythrocyte Sedimentation Rate (ESR), C-Reactive Protein (CRP), and D-dimer exhibited significant differences between the two groups. The average duration of vasopressor usage and Intensive Care Unit (ICU) stay were significantly reduced in the albumin infusion group (3.50±1.55 days and 8.70±4.20 days, respectively) compared to no albumin infusion group (4.33±1.05 days and 12.80±3.43 days, respectively). The albumin infusion group also displayed a lower incidence of Renal Replacement Therapy (RRT) and poorer ICU outcomes.
Conclusion: The intravenous administration of albumin did not exhibit a significant impact on mortality. However, albumin transfusion in patients with severe COVID-19 who initially had albumin levels <3 g/dL demonstrated a notable reduction in the requirement for vasopressors, RRT, and the length of ICU stay.
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