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COVID19 生物标志物:系统评价给我们带来了哪些启示?

COVID19 biomarkers: What did we learn from systematic reviews?

机构信息

College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates.

出版信息

Front Cell Infect Microbiol. 2022 Dec 13;12:1038908. doi: 10.3389/fcimb.2022.1038908. eCollection 2022.

Abstract

The coronavirus disease 2019 (COVID19) pandemic continues to represent a substantial public health concern. It can rapidly progress to severe disease, with poor prognosis and a high mortality risk. An early diagnosis and specific prognostic tools can help healthcare providers to start interventions promptly, understand the likely prognosis and to identify and treat timely individuals likely to develop severe disease with enhanced mortality risk. Here we focused on an impressive set of systematic reviews and meta-analyses that were performed since the start of the COVID19 pandemic and summarized their results related to the levels of hematologic, inflammatory, immunologic biomarkers as well as markers of cardiac, respiratory, hepatic, gastrointestinal and renal systems and their association with the disease progression, severity and mortality. The evidence outlines the significance of specific biomarkers, including inflammatory and immunological parameters (C-reactive protein, procalcitonin, interleukin-6), hematological (lymphocytes count, neutrophil-to-lymphocyte ratio, D-dimer, ferritin, red blood cell distribution width), cardiac (troponin, CK-MB, myoglobin), liver (AST, ALT, total bilirubin, albumin) and lung injury (Krebs von den Lungen-6) that can be used as prognostic biomarkers to aid the identification of high-risk patients and the prediction of serious outcomes, including mortality, in COVID19. Thus, these parameters should be used as essential tools for an early risk stratification and adequate intervention in improving disease outcomes in COVID19 patients.

摘要

新型冠状病毒病 2019(COVID19)大流行仍然是一个重大的公共卫生关注点。它可能迅速发展为严重疾病,预后不良,死亡率高。早期诊断和特定的预后工具可以帮助医疗保健提供者及时开始干预,了解可能的预后,并及时识别和治疗可能发展为严重疾病且死亡率风险增加的个体。在这里,我们重点关注了一组自 COVID19 大流行开始以来进行的令人印象深刻的系统评价和荟萃分析,并总结了它们与血液学、炎症、免疫学标志物以及心脏、呼吸、肝脏、胃肠道和肾脏系统标志物相关的结果,以及它们与疾病进展、严重程度和死亡率的关系。这些证据突出了特定生物标志物的重要性,包括炎症和免疫参数(C 反应蛋白、降钙素原、白细胞介素 6)、血液学(淋巴细胞计数、中性粒细胞与淋巴细胞比值、D-二聚体、铁蛋白、红细胞分布宽度)、心脏(肌钙蛋白、CK-MB、肌红蛋白)、肝脏(AST、ALT、总胆红素、白蛋白)和肺部损伤(Krebs von den Lungen-6),这些标志物可用作预后生物标志物,以帮助识别高危患者,并预测 COVID19 中的严重结局,包括死亡率。因此,这些参数应作为 COVID19 患者早期风险分层和充分干预以改善疾病结局的重要工具。

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