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Dynamic albumin values as clinical surrogate for COVID-19 therapeutics
  1. Johanna S van Zyl1,2,
  2. Joost Felius1,2,
  3. Amit Alam2,3,4,
  4. Shelley A Hall2,3,4,
  5. Aayla K Jamil1,2,
  6. Cedric W Spak5,6,
  7. Robert L Gottlieb1,2,3,4,7
  1. 1 Baylor Scott & White Research Institute, Baylor Scott & White Health, Dallas, Texas, USA
  2. 2 Texas A&M University Health Science Center, Dallas, Texas, USA
  3. 3 Center for Advanced Heart and Lung Disease, Baylor University Medical Center, Dallas, Texas, USA
  4. 4 Division of Cardiology, Baylor University Medical Center, Dallas, TX, USA
  5. 5 Division of Infectious Disease, Baylor University Medical Center, Dallas, Texas, USA
  6. 6 Texas Centers for Infectious Disease Associates, Dallas, Texas, USA
  7. 7 Division of Precision Medicine, Baylor University Medical Center, Dallas, TX, USA
  1. Correspondence to Dr Robert L Gottlieb, Center for Advanced Heart and Lung Disease, 3410 Worth St, Suite 250, Baylor University Medical Center, Dallas, TX 75246, USA; robert.gottlieb{at}

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We are delighted to see a letter to the editor1 essentially agreeing with the message conveyed through our retrospective observation: that a dynamic, accelerated fall of albumin levels in patients admitted with severe COVID-19 predicts progression to critical COVID-19.2 Our express intent was to spur further clinical investigation.

Our conclusion remains unchanged after accounting for pre-existing liver disease. COVID-19 frequently causes a self-limited transaminitis in patients without liver disease. Liver function measured at hospital admission using alanine aminotransferase and aspartate aminotransferase for the patients in our study who progressed to critical disease, compared with those who did not progress, was similar (table …

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  • Contributors Response first draft by RLG. Major revisions by JSvZ and JF with agreement and concurrence of all authors. All authors have discussed content and approved response.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

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