Significant differences were observed among the lowest level of serum albumin quartiles with respect to age, sex, smoking status, WBC, L, Hb, CRP, D-dimer, BUN, SCR, cerebrovascular disease, coinfection, sepsis, initial COVID-19 stage, antiviral treatment, acute respiratory failure, shock, death, and adverse outcomes (P < .05). This evidence concerns the gene ALB and respiratory failure.