Mahat Roshan Kumar, Panda Suchismita, Rathore Vedika, Swain Sharmistha, Yadav Lalendra, Sah Sumesh Prasad
Department of Biochemistry, Pandit Raghunath Murmu Medical College and Hospital, Baripada, Mayurbhanj, Odisha, 757107, India.
Department of Biochemistry, Shyam Shah Medical College, Rewa, Madhya Pradesh, 486001, India.
Clin Epidemiol Glob Health. 2021 Jul-Sep;11:100727. doi: 10.1016/j.cegh.2021.100727. Epub 2021 Mar 20.
Coronavirus disease-2019 (COVID-19) is a global pandemic and high mortality rate among severe or critical COVID-19 is linked with SARS-CoV-2 infection-induced hyperinflammation of the innate and adaptive immune systems and the resulting cytokine storm. This paper attempts to conduct a systematic review and meta-analysis of published articles, to evaluate the association of inflammatory parameters with the severity and mortality in COVID-19 patients.
A comprehensive systematic literature search of medical electronic databases including Pubmed/Medline, Europe PMC, and Google Scholar was performed for relevant data published from January 1, 2020 to June 26, 2020. Observational studies reporting clear extractable data on inflammatory parameters in laboratory-confirmed COVID-19 patients were included. Screening of articles, data extraction and quality assessment were carried out by two authors independently. Standardized mean difference (SMD)/mean difference (MD/WMD) and 95% confidence intervals (CIs) were calculated using random or fixed-effects models.
A total of 83 studies were included in the meta-analysis. Of which, 54 studies were grouped by severity, 25 studies were grouped by mortality, and 04 studies were grouped by both severity and mortality. Random effect model results demonstrated that patients with severe COVID-19 group had significantly higher levels of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), procalcitonin (PCT), interleukin-6 (IL-6), interleukin-10 (IL-10), interleukin-2R (IL-2R), serum amyloid A (SAA) and neutrophil-to-lymphocyte ratio (NLR) compared to those in the non-severe group. Similarly, the fixed-effect model revealed significant higher ferritin level in the severe group when compared with the non-severe group. Furthermore, the random effect model results demonstrated that the non-survivor group had significantly higher levels of CRP, PCT, IL-6, ferritin, and NLR when compared with the survivor group.
In conclusion, the measurement of these inflammatory parameters could help the physicians to rapidly identify severe COVID-19 patients, hence facilitating the early initiation of effective treatment.
CRD42020193169.
2019冠状病毒病（COVID-19）是一场全球大流行疾病，重症或危重症COVID-19患者的高死亡率与严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染引起的固有免疫和适应性免疫系统过度炎症反应以及由此产生的细胞因子风暴有关。本文试图对已发表的文章进行系统综述和荟萃分析，以评估炎症参数与COVID-19患者严重程度和死亡率之间的关联。
对包括Pubmed/Medline、欧洲生物医学中心（Europe PMC）和谷歌学术（Google Scholar）在内的医学电子数据库进行全面的系统文献检索，以获取2020年1月1日至2020年6月26日发表的相关数据。纳入报告实验室确诊的COVID-19患者炎症参数明确可提取数据的观察性研究。由两位作者独立进行文章筛选、数据提取和质量评估。使用随机或固定效应模型计算标准化均数差（SMD）/均数差（MD/加权均数差[WMD]）和95%置信区间（CIs）。
荟萃分析共纳入83项研究。其中，54项研究按严重程度分组，25项研究按死亡率分组，4项研究按严重程度和死亡率分组。随机效应模型结果表明，与非重症组相比，重症COVID-19组患者的C反应蛋白（CRP）、红细胞沉降率（ESR）、降钙素原（PCT）、白细胞介素-6（IL-6）、白细胞介素-10（IL-10）、白细胞介素-2受体（IL-2R）、血清淀粉样蛋白A（SAA）和中性粒细胞与淋巴细胞比值（NLR）水平显著更高。同样，固定效应模型显示，与非重症组相比，重症组铁蛋白水平显著更高。此外，随机效应模型结果表明，与存活组相比，非存活组的CRP、PCT、IL-6、铁蛋白和NLR水平显著更高。
总之，这些炎症参数的测量有助于医生快速识别重症COVID-19患者，从而促进早期开始有效治疗。
CRD42020193169。
