Association between hypoalbuminemia and pulmonary CT severity in COVID-19 ICU patients: A cohort study

Variable parameters	Mean ± SD	Min–Max
Systolic blood pressure (mmHg)	129.79 ± 22.07	90–250
Diastolic blood pressure (mmHg)	79.69 ± 12.33	58–30
Heart rate (per min)	99.23 ± 19.49	52–;158
Respiratory rate (per min)	20.08 ± 3.89	14–45
Laboratory findings
Albumin (g/dL)	3.13 ± 0.49	1.80–4.40
CRP (mg/dL)	127.02 ± 83.88	0.50–395
BUN (mg/dL)	45.33 ± 20.36	9–120
Creatinine (mg/dL)	0.99 ± 0.25	0.30–1.90
AST (u/L)	46.40 ± 22.69	8–174
ALT (μ/L)	37.16 ± 24.65	6–;134
ALP (μ/L)	206.31 ± 95.64	29–657
WBC (109/L	10.43 ± 7.23	0.8–75
Haemoglobin (g/dL)	13.10 ± 2.22	5.50–19.50
Platelets	214.09 ± 89.54	3–486
Lymphocytes (%)	11.74 ± 6.91	0.80–40.80

1 CRP, C-reactive protein; SD, standard deviation.

Comparison of serum albumin levels in survivors and non-survivors.

Parameters	Survivors (mean ± SD)	Non-survivors (mean ± SD)	95% CI for the difference between survivors and non-survivors	P-value	Cohen’s d
First albumin (g/dL)	3.30 ± 0.35	3.09 ± 0.51	(0.07, 0.35)	0.003	0.43
Second albumin (g/dL)	3.17 ± 0.41	2.81 ± 0.53	(0.11,0.77)	0.006	0.72
TSS on first CT	13.20 ± 5.24	13.11 ± 5.63	(-1.96, 0.63)	0.934	0.02

1 CT, computed tomography; TSS, total severity score; SD, standard deviation.

Albumin levels in the initial and subsequent measurements are significantly higher in living individuals compared to deceased individuals.

Comparison of TSS and serum albumin.

Parameters	Hypoalbuminemia	Normal serum albumin	95% CI for the difference	P-value	Cohen’s p
TSS on first CT scan (mean ± SD)	13.42 ± 5.24	11.71 ± 6.68	(–4.13,0.72)	0.163	–0.31

1 CT, computed tomography; SD, standard deviation; TSS, total severity score in lung CT.

Comparison of TSS levels among degrees of hypoalbuminemia.

	Hypoalbuminemia						Normal Serum albumin (n=36)		P-value	Eta squared
	Severe(n=3)		Moderate(n=71)		Mild (n=86)		Normal Serum albumin (n=36)		P-value	Eta squared
TSS on first CT scan	15.67 ± 1.53		13.08 ± 5.76		13.62 ± 4.85		15.67 ± 1.53		0.312	0.02
Comparison between	Alive	Expired (n = 3)	Alive (n = 6)	Expired (n = 65)	Alive (n = 21)	Expired (n = 65)	Alive (n = 10)	Expired (n = 26)
TSS on first CT scan	–	15.67 ± 1.53	16.83 ± 2.32	12.74 ± 5.87	12.29 ± 5.56	14.05 ± 4.57	12.56 ± 4.98	11.42 ± 7.23
P-value	–		0.005		0.150		0.609
Eta squared	–		0.720		–0.365		0168

1 CT, computed tomography; TSS, total severity score.

Logistic regression results.

Unadjusted logistic regression				Adjusted logistic regression
Variables	Coefficient	OR	P-value	Variables	Coefficient	OR	95% CI	P-value
Gender (male)	–0.27	0.77	0.475	Age (years)	0.01	1.01	(0.99, 1.04)	0.262
Age (years)	0.02	1.02	0.060	Hypertension	0.53	1.69	(0.76, 3.79)	0.198
Diabetes	0.09	0.95	0.794	Albumin	–0.92	0.39	(0.18, 0.90)	0.027
COPD	0.29	1.10	0.615
IHD	0.39	1.48	0.361
Hypertension	0.62	1.86	0.103
Intubation	–0.31	0.89	0.632
Albumin	–0.95	0.39	0.020
CT score	0.00	1.00	0.998
CRP	0.002	1.002	0.481

1 COPD, chronic obstructive pulmonary disease; CRP, C-reactive protein; CT, computed tomography.

DOI: https://doi.org/10.2478/pneum-2025-0039 | Journal eISSN: 2247-059X | Journal ISSN: 2067-2993

Language: English, Romanian

Page range: 143 - 148

Published on: Feb 19, 2026

Published by: Romanian Society of Pneumology

In partnership with: Paradigm Publishing Services

Publication frequency: Volume open

Keywords:

Related subjects:

© 2026 Farzaneh Akbari, Mohammad Ami Jaberi Mofradn, Fariba Rezaeetalab, Elham Shaarbaf Eidgah, published by Romanian Society of Pneumology
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.