Yong Shin Jie, Halim Alice, Halim Michael, Liu Shiliang, Aljeldah Mohammed, Al Shammari Basim R, Alwarthan Sara, Alhajri Mashael, Alawfi Abdulsalam, Alshengeti Amer, Khamis Faryal, Alsalman Jameela, Alshukairi Abeer N, Abukhamis Nujoud A, Almaghrabi Fatimah S, Almuthree Souad A, Alsulaiman Abdulrahman M, Alshehail Bashayer M, Alfaraj Amal H, Alhawaj Shorouq A, Mohapatra Ranjan K, Rabaan Ali A
Department of Biological Sciences, School of Medical and Life Sciences, Sunway University, Selangor, Malaysia.
Shanghai Medical College, Fudan University, Shanghai, China.
Rev Med Virol. 2023 Mar;33(2):e2424. doi: 10.1002/rmv.2424. Epub 2023 Jan 27.
Severe acute respiratory syndrome coronavirus 2 may inflict a post-viral condition known as post-COVID-19 syndrome (PCS) or long-COVID. Studies measuring levels of inflammatory and vascular biomarkers in blood, serum, or plasma of COVID-19 survivors with PCS versus non-PCS controls have produced mixed findings. Our review sought to meta-analyse those studies. A systematic literature search was performed across five databases until 25 June 2022, with an updated search on 1 November 2022. Data analyses were performed with Review Manager and R Studio statistical software. Twenty-four biomarkers from 23 studies were meta-analysed. Higher levels of C-reactive protein (Standardized mean difference (SMD) = 0.20; 95% CI: 0.02-0.39), D-dimer (SMD = 0.27; 95% CI: 0.09-0.46), lactate dehydrogenase (SMD = 0.30; 95% CI: 0.05-0.54), and leukocytes (SMD = 0.34; 95% CI: 0.02-0.66) were found in COVID-19 survivors with PCS than in those without PCS. After sensitivity analyses, lymphocytes (SMD = 0.30; 95% CI: 0.12-0.48) and interleukin-6 (SMD = 0.30; 95% CI: 0.12-0.49) were also significantly higher in PCS than non-PCS cases. No significant differences were noted in the remaining biomarkers investigated (e.g., ferritin, platelets, troponin, and fibrinogen). Subgroup analyses suggested the biomarker changes were mainly driven by PCS cases diagnosed via manifestation of organ abnormalities rather than symptomatic persistence, as well as PCS cases with duration of <6 than ≥6 months. In conclusion, our review pinpointed certain inflammatory and vascular biomarkers associated with PCS, which may shed light on potential new approaches to understanding, diagnosing, and treating PCS.
严重急性呼吸综合征冠状病毒2可能引发一种病毒后病症，称为新冠后综合征（PCS）或长期新冠。对患有PCS的新冠幸存者与无PCS的对照组的血液、血清或血浆中的炎症和血管生物标志物水平进行测量的研究结果不一。我们的综述旨在对这些研究进行荟萃分析。在2022年6月25日之前，我们在五个数据库中进行了系统的文献检索，并于2022年11月1日进行了更新检索。使用Review Manager和R Studio统计软件进行数据分析。对23项研究中的24种生物标志物进行了荟萃分析。与无PCS的新冠幸存者相比，患有PCS的新冠幸存者的C反应蛋白水平更高（标准化均数差（SMD）=0.20；95%置信区间：0.02-0.39）、D-二聚体（SMD=0.27；95%置信区间：0.09-0.46）、乳酸脱氢酶（SMD=0.30；95%置信区间：0.05-0.54）和白细胞（SMD=0.34；95%置信区间：0.02-0.66）。经过敏感性分析，PCS患者的淋巴细胞（SMD=0.30；95%置信区间：0.12-0.48）和白细胞介素-6（SMD=0.30；95%置信区间：0.12-0.49）也显著高于无PCS患者。在所研究的其余生物标志物（如铁蛋白、血小板、肌钙蛋白和纤维蛋白原）中未发现显著差异。亚组分析表明，生物标志物的变化主要由通过器官异常表现而非症状持续时间诊断的PCS病例以及病程<6个月而非≥6个月的PCS病例驱动。总之，我们的综述确定了某些与PCS相关的炎症和血管生物标志物，这可能为理解、诊断和治疗PCS的潜在新方法提供线索。
