{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T18:56:52Z","timestamp":1783537012065,"version":"3.55.0"},"reference-count":20,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"\n Background<\/jats:title>\n While systemic inflammation is a hallmark of severe COVID-19, the prognostic value of metabolic and organ-functional markers remains under-explored. This study examined the prognostic value of serum albumin and blood urea at hospital admission in predicting in-hospital mortality among patients with COVID-19.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We performed a retrospective cohort study of 1,074 adult patients with laboratory-confirmed COVID-19 who were hospitalized in a tertiary care center. Patients\u2019 demographic, clinical and laboratory data on admission were collected from electronic medical records. We conducted multivariable logistic regression analyses to determine independent predictors of in-hospital death after adjusting for possible confounders including age, sex, comorbidities and known inflammatory\/coagulation markers. Missing laboratory variables were imputed by multiple imputation by chained equations. Area under the receiver Operating characteristics curve (AUC) was evaluated for model discrimination.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n In-hospital mortality occurred in (24.5%). Non-survivors had significantly lower serum albumin and higher blood urea levels at admission. After full adjustment, hypoalbuminemia remained independently associated with increased mortality risk. Each 10 mg\/dL increase in urea was associated with a 14% increase in the odds of death (AOR\u2009=\u20091.14, 95% CI 1.08\u20131.20), whereas albumin demonstrated an independent protective association with mortality (AOR\u2009=\u20090.52, 95% CI 0.37\u20130.74). The final multivariable model demonstrated good discrimination (AUC\u2009=\u20090.86), indicating strong predictive ability.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Serum albumin and blood urea at hospital admission independently predict mortality in patients with COVID-19, even after accounting for inflammatory and coagulation markers. These findings suggest that markers of organ-functional reserve may provide prognostic information beyond traditional inflammatory markers in hospitalized patients with COVID-19.<\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pone.0353456","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T17:38:53Z","timestamp":1783532333000},"page":"e0353456","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Serum albumin and blood urea as independent predictors of in-hospital mortality in hospitalized COVID-19 patients: A retrospective cohort 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