Loomba Rohit S, Villarreal Enrique G, Farias Juan S, Aggarwal Gaurav, Aggarwal Saurabh, Flores Saul
Department of Pediatric Critical Care, Advocate Children's Hospital, Oak Lawn, IL, USA.
Department of Pediatrics, Chicago Medical School/Rosalind Franklin University of Medicine and Science, Chicago, IL, USA.
Ann Clin Biochem. 2022 Jan;59(1):15-22. doi: 10.1177/00045632211014244. Epub 2021 May 14.
There is limited information regarding the role of biomarker levels at predicting mortality in patients with the coronavirus disease (COVID-19) pandemic. The purpose of this study is to determine the differences in serum biomarker levels in adults with COVID-19 who survived hospitalization from those who did not.
A comprehensive search was completed on PubMed, EMBASE and Cochrane libraries to identify studies of interest. Endpoints of interest were blood counts, hepatic function test, acute phase reactants, cytokines and cardiac biomarkers.
A total of 10 studies with 1584 patients were included in the pooled analyses. Biomarkers that were noted to be significantly higher in those who died from coronavirus disease included: white blood cell count, neutrophil count, C-reactive protein, high sensitivity C-reactive protein, procalcitonin, ferritin, D-dimer, interleukin-6, lactate dehydrogenase, creatine kinase, prothrombin time, aspartate aminotransferase, alanine aminotransferase, total bilirubin and creatinine. Lymphocyte count, platelet count and albumin were significantly lower in patients who died.
This pooled analysis of 10 studies including 1584 patients identified significant differences in biomarkers on admission in patients who survived from those who did not. Further research is needed to develop risk stratification models to help with judicious use of limited health-care resources.
关于生物标志物水平在预测冠状病毒病（COVID-19）大流行患者死亡率方面的作用，相关信息有限。本研究的目的是确定COVID-19成年患者中，存活出院者与未存活者血清生物标志物水平的差异。
对PubMed、EMBASE和Cochrane图书馆进行全面检索，以确定感兴趣的研究。感兴趣的终点指标包括血细胞计数、肝功能检查、急性期反应物、细胞因子和心脏生物标志物。
共有10项研究、1584例患者纳入汇总分析。在死于冠状病毒病的患者中，显著升高的生物标志物包括：白细胞计数、中性粒细胞计数、C反应蛋白、高敏C反应蛋白、降钙素原、铁蛋白、D-二聚体、白细胞介素-6、乳酸脱氢酶、肌酸激酶、凝血酶原时间、天冬氨酸转氨酶、丙氨酸转氨酶、总胆红素和肌酐。死亡患者的淋巴细胞计数、血小板计数和白蛋白水平显著较低。
这项对10项研究（包括1584例患者）的汇总分析确定了存活者与未存活者入院时生物标志物的显著差异。需要进一步研究以开发风险分层模型，以帮助明智地使用有限的医疗资源。
