Association of hypoalbuminemia and reversal of albumin-to-globulin ratio with morbidity outcome among hospitalized Lassa fever infected patients at a dedicated treatment center in Ondo state, south-western Nigeria

Sampson Omagbemi Owhin; Chukwuyem Abejegah; Olumuyiwa John Fasipe; Clement Oke; Abiodun Abidoye; Austine Osagbaekhoe; Abimbola Awe; Ijeoma Etafo; Evbaruese Iredia; Olufemi Ayodeji; Lanre Olatunde; Olalekan Ojo; Josephine Alabi; Peter Ehizokhale Akhideno; Harrison Ejiyere; Azuka Stephen Adeke; Joachim Azegbeobor; Liasu Ahmed

doi:10.2144/fsoa-2020-0075

Association of hypoalbuminemia and reversal of albumin-to-globulin ratio with morbidity outcome among hospitalized Lassa fever infected patients at a dedicated treatment center in Ondo state, south-western Nigeria

Future Sci OA. 2020 Aug 13;6(10):FSO620. doi: 10.2144/fsoa-2020-0075.

Authors

Sampson Omagbemi Owhin¹, Chukwuyem Abejegah², Olumuyiwa John Fasipe³, Clement Oke², Abiodun Abidoye², Austine Osagbaekhoe², Abimbola Awe², Ijeoma Etafo², Evbaruese Iredia², Olufemi Ayodeji², Lanre Olatunde¹, Olalekan Ojo¹, Josephine Alabi⁴, Peter Ehizokhale Akhideno⁵, Harrison Ejiyere⁵, Azuka Stephen Adeke⁶, Joachim Azegbeobor⁷, Liasu Ahmed⁸

Affiliations

¹ Department of Internal Medicine and Hemato-oncology Unit, Federal Medical Center Owo, Ondo State, Nigeria.
² Department of Community Medicine, Federal Medical Center Owo, Ondo State, Nigeria.
³ Department of Clinical Pharmacology and Therapeutics, Faculty of Basic Clinical Sciences, University of Medical Sciences, Ondo City, Ondo State, Nigeria.
⁴ Department of Nursing, Federal Medical Center Owo, Ondo State, Nigeria.
⁵ Department of Internal Medicine, Irrua Specialist Teaching Hospital Irrua, Edo State, Nigeria.
⁶ Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi State, Nigeria.
⁷ Department of Psychiatry, Federal Medical Center Owo, Ondo State, Nigeria.
⁸ Office of the Chief Medical Director, Federal Medical Center, Owo, Ondo State, Nigeria.

Abstract

Background: As of this present moment, there is paucity of data on report concerning the association between hypoalbuminaemia or reversal of albumin-to-globulin ratio and morbidity outcome in Lassa fever (LF) infection as a crucial determinant prognostic-predictor factor for treatment-survival outcome.

Aim: This study was designed to determine the association between hypoalbuminaemia, reversal of albumin-to-globulin ratio and morbidity outcome among confirmed LF infected patients.

Methodology: This was a descriptive retrospective study involving the assessment of records of confirmed LF infected patients that were managed at the center from November 2018 to October 2019.

Results: Out of 83 recruited participants with complete records, 66 (79.5%) had hypoalbuminaemia, 74 (89.2%) had reversal of albumin-to-globulin ratio. A higher mean value of total white blood cell (WBC) count was observed among patients with hypoalbuminaemia (p < 0.0001) and reversal of albumin-to-globulin ratio (p < 0.0001) when compared to patients with normal values, respectively. Also, this study showed statistically significant associations between serum albumin level versus total WBC count (p < 0.0001), acute kidney injury (AKI; p = 0.009), bleeding diathesis (p < 0.0001), and occurrence of pregnancy miscarriage (p < 0.0001).

Conclusion: There is a baseline hypoalbuminaemia and reversal of albumin-to-globulin ratio among confirmed LF infected patients. Based on these findings, the serum level of albumin and albumin-to-globulin ratio at presentation may serve as simple early biomarkers to identify patients at high risk for a complicated clinical course of disease. This study also reveals that those hospitalized LF infected patients with hypoalbuminemia and/or reversal of albumin-to-globulin ratio tend to have leucocytosis and experience prolonged duration of illness.

Keywords: Federal Medical Center Owo; Lassa fever infection; Nigeria; hospitalized; hypoalbuminemia; morbidity outcome; reversal of albumin-to-globulin ratio.