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Meta-Analysis
. 2021 Mar:41:110-119.
doi: 10.1016/j.ajem.2020.12.076. Epub 2020 Dec 30.

Inflammatory and hematologic markers as predictors of severe outcomes in COVID-19 infection: A systematic review and meta-analysis

Timotius Ivan Hariyanto  1 , Karunia Valeriani Japar  2 , Felix Kwenandar  3 , Vika Damay  4 , Jeremia Immanuel Siregar  5 , Nata Pratama Hardjo Lugito  6 , Margaret Merlyn Tjiang  7 , Andree Kurniawan  8
Affiliations
Meta-Analysis

Inflammatory and hematologic markers as predictors of severe outcomes in COVID-19 infection: A systematic review and meta-analysis

Timotius Ivan Hariyanto et al. Am J Emerg Med. 2021 Mar.

Abstract

Background: Laboratory testing is commonly performed in patients with COVID-19. Each of the laboratory parameters has potential value for risk stratification and prediction of COVID-19 outcomes. This systematic review and meta-analysis aimed to evaluate the difference between these parameters in severe and nonsevere disease and to provide the optimal cutoff value for predicting severe disease.

Method: We performed a systematic literature search through electronic databases. The variables of interest were serum procalcitonin, albumin, C-reactive protein (CRP), D-dimer, and lactate dehydrogenase (LDH) levels in each group of severity outcomes from COVID-19.

Results: There were a total of 4848 patients from 23 studies. Our meta-analysis suggest that patients with severe COVID-19 infections have higher procalcitonin, (mean difference 0.07; 95% CI 0.05-0.10; p < 0.00001), CRP (mean difference 36.88; 95% CI 29.10-44.65; p < 0.00001), D-Dimer (mean difference 0.43; 95% CI 0.31-0.56; p < 0.00001), and LDH (mean difference 102.79; 95% CI 79.10-126.49; p < 0.00001) but lower levels of albumin (mean difference -4.58; 95% CI -5.76 to -3.39; p < 0.00001) than those with nonsevere COVID-19 infections. The cutoff values for the parameters were 0.065 ng/mL for procalcitonin, 38.85 g/L for albumin, 33.55 mg/L for CRP, 0.635 μ/L for D-dimer, and 263.5 U/L for LDH, each with high sensitivity and specificity.

Conclusion: This meta-analysis suggests elevated procalcitonin, CRP, D-dimer, and LDH and decreased albumin can be used for predicting severe outcomes in COVID-19.

Keywords: Biomarker; COVID-19; Coronavirus; Laboratory; SARS-CoV-2.

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Conflict of interest statement

Declaration of Competing Interest The authors declare no conflict of interest regarding this article.

Figures

Fig. 1
Fig. 1
PRISMA diagram of the detailed process of selection of studies for inclusion in the systematic review and meta analysis.
Fig. 2
Fig. 2
Forest-plot analysis for serum albumin (A), CRP (B), D-Dimer (C), LDH (D), and procalcitonin (E) in severe and non-severe COVID-19.
Fig. 3
Fig. 3
ROC-curve analysis for serum albumin (A), CRP (B), D-Dimer (C), LDH (D), and procalcitonin (E) for predicting severe COVID-19 infection.
Fig. 4
Fig. 4
Funnel-plot analysis for serum albumin (A), CRP (B), D-Dimer (C), LDH (D), and procalcitonin (E).
See this image and copyright information in PMC

Comment in

References

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