Evaluation of ischemia-modified albumin in the diagnosis and the clinical severity of COVID-19 in children

• Published in: The Turkish journal of pediatrics Vol. 65; no. 3; pp. 425 - 432
• Main Authors: Öncel, Eda Karadağ, Yılmaz, Dilek, Kara Aksay, Ahu, Neşelioğlu, Salim, İşbilen Başok, Banu, Karakoyun, İnanç, Altan, Tuba Kansu, Taşar, Selin, Üstündağ, Gülnihan, Şahin, Aslıhan, Keleş, Yıldız Ekemen, Tüz, Ayşegül Elvan, Erel, Özcan
• Format: Journal Article
• Language: English
• Published: Turkey Akdema Informatics and Publishing 2023; Hacettepe University Institute of Child Health
• Subjects: Albumin; Biomarkers - metabolism; C-reactive protein; Case-Control Studies; Child; Children; clinical severity; COVID-19; COVID-19 - diagnosis; COVID-19 Testing; Diagnosis; Ferritin; Humans; Infection; Ischemia; ischemia-modified albumin; Serum Albumin; Serum Albumin, Human - metabolism; Taiwan; COVID-19; diagnosis; ischemia-modified albumin; clinical severity; child
• ISSN: 0041-4301; 2791-6421
• DOI: 10.24953/turkjped.2022.232

Background. There is no specific biomarker used in the diagnosis of COVID-19 and predicting its clinical severity. This study aimed to investigate the utility of ischemia-modified albumin (IMA) in diagnosing and predicting clinical severity in children with COVID-19. Methods. Between October 2020 and March 2021, 41 cases constituted the COVID-19 group and 41 cases constituted the healthy control group. IMA levels were measured at admission (IMA-1) and 48-72 hours (IMA- 2) in the COVID-19 group. In the control group, it was measured at admission. COVID-19 clinical severity was classified as asymptomatic infection, mild, moderate, severe, or critical disease. Patients were divided into two groups (asymptomatic/mild and moderate/severe) to evaluate IMA levels in terms of clinical severity. Results. In the COVID-19 group, the mean IMA-1 level was 0.901±0.099, and the mean IMA-2 level was 0.866±0.090. The mean level of IMA-1 in the control group was 0.787±0.051. When IMA-1 levels of COVID-19 and control cases were compared, the difference was statistically significant (p < 0.001). When clinical severity and laboratory data are compared, C-reactive protein, ferritin and ischemia-modified albumin ratio (IMAR) were statistically significantly higher in moderate-severe clinical cases (p=0.034, p=0.034, p=0.037 respectively). However, IMA-1 and IMA-2 levels were similar between the groups (p=0.134, p=0.922, respectively). Conclusions. To date, no study has been conducted on IMA levels in children with COVID-19. The IMA level may be a new marker for the diagnosis of COVID-19 in children. Studies with a larger number of cases are needed to predict clinical severity.