School of Public Health, North China University of Science and Technology, Tangshan, China.
School of Life Science, North China University of Science and Technology, Tangshan, China.
Scand J Clin Lab Invest. 2021 Dec;81(8):679-686. doi: 10.1080/00365513.2021.2000635. Epub 2021 Nov 11.
Understanding factors associated with disease severity and mortality from coronavirus disease (COVID-19) was critical for effective risk stratification. We aimed to investigate the association between biomarkers of clinical laboratory tests, including serum C-reactive protein (CRP), serum amyloid protein (SAA), lactate dehydrogenase (LDH), and D-dimer (DD) and poor prognosis of COVID-19. We have searched many studies on COVID-19 on PubMed (Medline), Web of Science and Cochrane until 1 March 2021. The interest of this study was original articles reporting on laboratory testing projects and outcome of patients with COVID-19 that comprises mortality, acute respiratory distress syndrome (ARDS), need for care in an intensive care unit (ICU), and severe COVID-19. After synthesizing all data, we performed meta-analysis of random effects, and determined mean difference (MD) and standard mean difference at the biomarker level for different disease severity. A total of 7,739 patients with COVID-19 were pooled from 32 studies. CRP was significantly associated with poor prognosis of COVID-19 (SMD = 0.98, 95% CI = (0.85, 1.11), < .001). Elevated SAA was associated with an increased composite poor outcome in COVID-19 (SMD = 1.06, 95% CI = (0.39, 1.72), = .002). An elevated LDH was associated with a composite poor outcome (SMD = 1.18, 95% CI = (1.00, 1.36), < .001). Patients with a composite poor outcome had a higher DD level (SMD = 0.91, 95% CI = (0.79, 1.02), < .001). This meta-analysis showed that elevated serum CRP, SAA, LDH, and DD were associated with a poor outcome in COVID-19.
了解与冠状病毒病（COVID-19）疾病严重程度和死亡率相关的因素对于有效的风险分层至关重要。我们旨在研究临床实验室检查的生物标志物（包括血清 C 反应蛋白（CRP）、血清淀粉样蛋白（SAA）、乳酸脱氢酶（LDH）和 D-二聚体（DD））与 COVID-19 不良预后之间的关系。我们已经在 PubMed（Medline）、Web of Science 和 Cochrane 上搜索了许多关于 COVID-19 的研究，截至 2021 年 3 月 1 日。本研究的兴趣在于报告 COVID-19 患者实验室检测项目和结局的原始文章，这些结局包括死亡率、急性呼吸窘迫综合征（ARDS）、需要在重症监护病房（ICU）接受护理以及严重 COVID-19。对所有数据进行综合分析后，我们对不同疾病严重程度的随机效应进行了荟萃分析，并确定了生物标志物水平的平均差异（MD）和标准均数差。总共从 32 项研究中汇集了 7739 名 COVID-19 患者。CRP 与 COVID-19 的不良预后显著相关（SMD = 0.98，95%CI =（0.85，1.11），<0.001）。升高的 SAA 与 COVID-19 的复合不良结局增加相关（SMD = 1.06，95%CI =（0.39，1.72），=0.002）。升高的 LDH 与复合不良结局相关（SMD = 1.18，95%CI =（1.00，1.36），<0.001）。复合不良结局患者的 DD 水平较高（SMD = 0.91，95%CI =（0.79，1.02），<0.001）。这项荟萃分析表明，血清 CRP、SAA、LDH 和 DD 升高与 COVID-19 的不良预后相关。
