Evaluating the diagnostic and prognostic ability of ischemia modified albumin in COVID-19

Athanasios Pagonis; Athanasios Chalkias; Georgios Mavrovounis; Konstantinos Tourlakopoulos; Konstantinos Marsitopoulos; Nikolaos Papagiannakis; Maria Kechagia; Eleni Makri; Vasiliki Tsolaki; Zoe Daniil; Konstantinos Gourgoulianis; Ioannis Pantazopoulos

doi:10.1016/j.hrtlng.2024.03.003

Evaluating the diagnostic and prognostic ability of ischemia modified albumin in COVID-19

Heart Lung. 2024 Mar 22:66:16-22. doi: 10.1016/j.hrtlng.2024.03.003. Online ahead of print.

Affiliations

¹ Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Larissa, Greece.
² Institute for Translational Medicine and Therapeutics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA; Outcomes Research Consortium, Cleveland, OH, USA.
³ Department of Emergency Medicine, Faculty of Medicine, University of Thessaly, Larissa, Greece. Electronic address: gmavrovounis@gmail.com.
⁴ Department of Urology, Faculty of Medicine, University of Thessaly, Larissa, Greece.
⁵ 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece.
⁶ Hematology Laboratory, Sismanoglio General Hospital of Athens, Athens, Greece.
⁷ In Vitro Labs SA, Athens, Greece.
⁸ Department of Critical Care Medicine, Faculty of Medicine, University Hospital of Larissa, Larissa, Greece.
⁹ Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Larissa, Greece; Department of Emergency Medicine, Faculty of Medicine, University of Thessaly, Larissa, Greece.

PMID: 38520986
DOI: 10.1016/j.hrtlng.2024.03.003

Abstract

Background: Patients with COVID-19 can rapidly deteriorate and develop acute hypoxic respiratory failure. Prominent features of the disease include severe inflammation, endotheliitis, and thrombosis.

Objectives: The aim of the study was to evaluate the diagnostic and prognostic effectiveness of ischemia modified albumin (ΙΜΑ) in a cohort of COVID-19 patients.

Methods: This prospective observational study included adults with SARS-CoV-2 infection confirmed by reverse transcription polymerase chain reaction test, who were hospitalized specifically for COVID-19. The outcomes of interest were progression to severe acute respiratory failure during the index hospitalization defined as partial pressure of oxygen/fraction of inspired oxygen lower or equal to 150, admission to the intensive care unit (ICU) and in-hospital mortality. Admission IMA levels were determined using the commercially available "IMA Assay Kit" method (Abbexa LTD, Cambridge, UK). Adults without SARS-CoV-2 infection were used as controls.

Results: 135 COVID-19 patients and 64 controls were included. Admission IMA levels were significantly higher in COVID-19 patients compared to controls [[24.38 (11.94) ng/ml vs. 14.69 (3.52) ng/ml, p < 0.01]. Receiver operating characteristic analysis of admission IMA showed an area under the curve (AUC) of 94% (p < 0.0001) for COVID-19 diagnosis (cut-off value: 17.5 ng/ml; sensitivity: 90.37%; specificity: 87.5%). Admission IMA was also associated with mortality (AUC: 68%, p = 0.01). However, it was not associated with severe acute respiratory failure (AUC: 47%, p = 0.53) or ICU admission (AUC: 58%, p = 0.41).

Conclusion: Admission IMA was significantly increased in COVID-19 patients and was associated with in-hospital mortality.

Keywords: Covid-19; Diagnostic accuracy; Ischemia modified albumin; Outcome.