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Int J Infect Dis . Serum amyloid A concentrations, COVID-19 severity and mortality: an updated systematic review and meta-analysis

tetano

Editor, Senior Moderator
Int J Infect Dis


. 2021 Mar 15;S1201-9712(21)00243-5.
doi: 10.1016/j.ijid.2021.03.025. Online ahead of print.
Serum amyloid A concentrations, COVID-19 severity and mortality: an updated systematic review and meta-analysis


Angelo Zinellu[SUP] 1 [/SUP], Panagiotis Paliogiannis[SUP] 2 [/SUP], Ciriaco Carru[SUP] 3 [/SUP], Arduino A Mangoni[SUP] 4 [/SUP]



Affiliations

Abstract

Background and objectives: An excessive inflammatory response in patients with coronavirus disease 2019 (COVID-19) is associated with high disease severity and mortality. Specific acute phase reactants might be useful for risk stratification. We conducted a systematic review and meta-analysis of studies of serum amyloid A (SAA) in patients with COVID-19.
Methods: We searched PubMed, Web of Science and Scopus, between January 2020 and December 2020, for studies reporting SAA concentrations, COVID-19 severity and survival status.
Results: Nineteen studies in 5,617 COVID-19 patients were included in the meta-analysis. Pooled results showed that SAA concentrations were significantly higher in patients with severe disease and non-survivors (standard mean difference, SMD, 1.20, 95% CI 0.91-1.49, P < 0.001). Extreme between-study heterogeneity was observed (I[SUP]2[/SUP] = 92.4%, P < 0.001). In sensitivity analysis, the effect size was not significantly affected when each study was in turn removed (range between 1.10-1.29). The Begg's (P = 0.030), but not the Egger's (P = 0.385), test revealed the presence of publication bias. Pooled SMD values were significantly and positively associated with gender (t = 2.20, P = 0.047) and aspartate aminotransferase (t = 3.44, P = 0.014).
Conclusions: SAA concentrations were significantly and positively associated with higher COVID-19 severity and mortality. This acute phase reactant might assist with risk stratification and monitoring in this group.

Keywords: COVID-19; disease severity; mortality; serum amyloid A.
 
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