Observational studyPloS one2026
Serum albumin and blood urea as independent predictors of in-hospital mortality in hospitalized COVID-19 patients: A retrospective cohort study.
Observational study in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundWhile systemic inflammation is a hallmark of severe COVID-19, the prognostic value of metabolic and organ-functional markers remains under-explored. This study examined the prognostic value of serum albumin and blood urea at hospital admission in predicting in-hospital mortality among patients with COVID-19.
methodsWe performed a retrospective cohort study of 1,074 adult patients with laboratory-confirmed COVID-19 who were hospitalized in a tertiary care center. Patients' demographic, clinical and laboratory data on admission were collected from electronic medical records. We conducted multivariable logistic regression analyses to determine independent predictors of in-hospital death after adjusting for possible confounders including age, sex, comorbidities and known inflammatory/coagulation markers. Missing laboratory variables were imputed by multiple imputation by chained equations. Area under the receiver Operating characteristics curve (AUC) was evaluated for model discrimination.
resultsIn-hospital mortality occurred in (24.5%). Non-survivors had significantly lower serum albumin and higher blood urea levels at admission. After full adjustment, hypoalbuminemia remained independently associated with increased mortality risk. Each 10 mg/dL increase in urea was associated with a 14% increase in the odds of death (AOR = 1.14, 95% CI 1.08-1.20), whereas albumin demonstrated an independent protective association with mortality (AOR = 0.52, 95% CI 0.37-0.74). The final multivariable model demonstrated good discrimination (AUC = 0.86), indicating strong predictive ability.
conclusionsSerum albumin and blood urea at hospital admission independently predict mortality in patients with COVID-19, even after accounting for inflammatory and coagulation markers. These findings suggest that markers of organ-functional reserve may provide prognostic information beyond traditional inflammatory markers in hospitalized patients with COVID-19.
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