Low serum albumin and the risk of hospitalization in COVID-19 infection: A retrospective case-control study

Acharya, Roshan; Poudel, Dilli; Patel, Aakash; Schultz, Evan; Bourgeois, Michael; Paswan, Rishi; Stockholm, Scott; Batten, Macylen; Kafle, Smita; Atkinson, Amanda; Sarwar, Hafiz

BACKGROUND: The data on the COVID-19 patients who were discharged to self-quarantine is lacking. AIM: The aim of the study was to investigate the percentage of COVID-19 positive patients that were hospitalized within a three-week period after discharge from ED to self-quarantine. METHODS: The patients who had confirmed SARS-CoV-2 on RT-PCR of the nasopharyngeal swab and were discharged from ED of a tertiary care hospital in the USA to self-quarantine from March 01- July 31, 2020, were included. Patients were divided into two groups based on serum albumin levels and were followed up for three weeks to see if low level of albumin increased the risk of hospitalization. Univariate and multivariate logistic regression analyses were performed to study the effect of albumin level and outcomes. RESULTS: A total of 112 patients were included in the study out of which 65 had low serum albumin (<3.5 g/dL) and 47 had normal serum albumin (≥3.5 g/dL). More than 10% of patients discharged to self-quarantine needed hospitalization within three weeks. The Low albumin group had more co-morbidities at baseline. The low serum albumin group had 10 (15.38%) vs 2 (4.26%), p = 0.06 hospitalizations as compared to the normal serum albumin group. The multivariate logistic regression analysis did not reveal lower odds of hospitalization in the group with normal albumin, (OR 0.26, 95% CI 0.03–1.92, p = 0.19) after controlling for age, sex, and various co-morbidities. CONCLUSION: The low serum albumin was not associated with the risk of hospitalization in COVID-19 patients who were initially discharged to self-quarantine.