Ulloque-Badaracco Juan R, Mosquera-Rojas Melany D, Hernandez-Bustamante Enrique A, Alarcón-Braga Esteban A, Herrera-Añazco Percy, Benites-Zapata Vicente A
Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.
Sociedad Científica de Estudiantes de Medicina de la Universidad Peruana de Ciencias Aplicadas, Lima, Peru.
Heliyon. 2022 May 18;8(5):e09457. doi: 10.1016/j.heliyon.2022.e09457. eCollection 2022 May.
The albumin-to-globulin ratio (AGR) has been used to predict severity and mortality in infectious diseases. The aim of this study is to evaluate the prognostic value of the AGR in COVID-19 patients.
A systematic review and meta-analysis were conducted. We included observational studies assessing the association between the AGR values upon hospital admission and severity or all-cause mortality in COVID-19 patients. In the meta-analyses we used random effect models. Risk of bias was assessed using the Newcastle-Ottawa Scale (NOS). The effect measures were expressed as mean difference (MD) and their 95% confidence intervals (CI). We performed Egger's test and funnel plots to assess the publication bias.
The included studies had a total of 11356 patients corresponding to 31 cohort studies. Severe COVID-19 patients had lower AGR values than non-severe COVID-19 patients (mean difference (MD), -0.27; 95% IC, -0.32 to -0.22; p < 0.001; I = 88%). Non-survivor patients with COVID-19 had lower AGR values than survivor patients (MD, -0.29; 95% IC, -0.35 to -0.24; p < 0.001; I = 79%). In the sensitivity analysis, we only included studies with low risk of bias, which decreased the heterogeneity for both outcomes (severity, I = 20%; mortality, I = 5%).
Low AGR values upon hospital admission were found in COVID-19 patients with a worse prognosis.
白蛋白与球蛋白比值（AGR）已被用于预测传染病的严重程度和死亡率。本研究的目的是评估AGR在新冠肺炎患者中的预后价值。
进行了一项系统评价和荟萃分析。我们纳入了评估新冠肺炎患者入院时AGR值与严重程度或全因死亡率之间关联的观察性研究。在荟萃分析中，我们使用随机效应模型。使用纽卡斯尔-渥太华量表（NOS）评估偏倚风险。效应量以平均差（MD）及其95%置信区间（CI）表示。我们进行了Egger检验和漏斗图分析以评估发表偏倚。
纳入的研究共有11356例患者，对应31项队列研究。重型新冠肺炎患者的AGR值低于非重型新冠肺炎患者（平均差（MD），-0.27；95%IC，-0.32至-0.22；p<0.001；I² = 88%）。新冠肺炎死亡患者的AGR值低于存活患者（MD，-0.29；95%IC，-0.35至-0.24；p<0.001；I² = 79%）。在敏感性分析中，我们仅纳入了偏倚风险低的研究，这降低了两种结局（严重程度，I² = 20%；死亡率，I² = 5%）的异质性。
入院时AGR值低的新冠肺炎患者预后较差。
