Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Thoracic Surgery, Union Hospital, Tongji Medical College Huazhong University of Science and Technology, Wuhan, China.
Nutrition. 2020 Oct;78:110930. doi: 10.1016/j.nut.2020.110930. Epub 2020 Jul 3.
High-risk patients ≥65 y of age with coronavirus disease 2019 (COVID-19) tended to have lower serum prealbumin concentrations. The aim of this study was to investigate the association of prealbumin at baseline on COVID-19-related mortality in elderly patients (≥65 y of age).
We non-selectively and consecutively collected participants from Tongji Hospital in Wuhan from January 17 to February 17, 2020. Univariate and multivariate logistic regression models were employed to evaluate the correlation between prealbumin and in-hospital outcomes (in-hospital mortality, admission to the intensive care unit [ICU], and mechanical ventilation) in elderly patients with COVID-19. Linear trend was performed by entering the median value of each category of prealbumin tertile as a continuous variable and was visually confirmed by using generalized additive models. Interaction and stratified analyses were conducted as well.
We included 446 elderly patients with COVID-19 in the final analyses. In-hospital mortality was 14.79%. Of the 446 patients, 15.47% were admitted to the ICU and 21.3% required mechanical ventilation. Compared with patients in the highest tertile, the prealbumin of patients in the lowest tertile had a 19.09-fold higher risk for death [odds ratio (OR), 20.09; 95% confidence interval (CI), 3.62-111.64; P = 0.0006], 25.39-fold higher risk for ICU admission (OR, 26.39; 95% CI, 4.04-172.39; P = 0.0006), and 1.8-fold higher risk for mechanical ventilation (OR, 2.8; 95% CI, 1.15-6.78; P = 0.0227) after adjustment for potential confounders. There was a linear trend correlation between serum prealbumin concentration and risk for in-hospital mortality, ICU admission, and mechanical ventilation in elderly patients with COVID-19 infection.
Prealbumin is an independent risk factor of in-hospital mortality for elderly patients with COVID-19. Assessment of prealbumin may help identify high-risk individuals ≥65 y of age with COVID-19.
患有 2019 年冠状病毒病（COVID-19）的高危老年患者（≥65 岁）血清前白蛋白浓度往往较低。本研究旨在探讨基线前白蛋白与老年患者（≥65 岁）COVID-19 相关死亡率的关系。
我们于 2020 年 1 月 17 日至 2 月 17 日从武汉同济医院非选择性、连续地收集参与者。采用单变量和多变量逻辑回归模型评估 COVID-19 老年患者中前白蛋白与住院结局（住院死亡率、入住重症监护病房[ICU]和机械通气）之间的相关性。通过将前白蛋白三分位 tertile 的中位数作为连续变量输入，进行线性趋势检验，并使用广义加性模型进行直观验证。还进行了交互作用和分层分析。
我们最终分析了 446 例 COVID-19 老年患者。住院死亡率为 14.79%。在 446 例患者中，15.47%入住 ICU，21.3%需要机械通气。与最高三分位组的患者相比，最低三分位组患者的死亡风险高 19.09 倍[优势比（OR），20.09；95%置信区间（CI），3.62-111.64；P=0.0006]，入住 ICU 的风险高 25.39 倍（OR，26.39；95%CI，4.04-172.39；P=0.0006），需要机械通气的风险高 1.80 倍（OR，2.8；95%CI，1.15-6.78；P=0.0227），经潜在混杂因素校正后。血清前白蛋白浓度与 COVID-19 感染老年患者住院死亡率、ICU 入院和机械通气风险之间存在线性趋势相关性。
前白蛋白是 COVID-19 老年患者住院死亡率的独立危险因素。评估前白蛋白可能有助于识别 COVID-19 高危患者（≥65 岁）。
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