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Scand J Clin Lab Invest . CRP, SAA, LDH, and DD predict poor prognosis of coronavirus disease (COVID-19): a meta-analysis from 7739 patients

tetano

Editor, Senior Moderator
Scand J Clin Lab Invest


. 2021 Nov 11;1-8.
doi: 10.1080/00365513.2021.2000635. Online ahead of print.
CRP, SAA, LDH, and DD predict poor prognosis of coronavirus disease (COVID-19): a meta-analysis from 7739 patients


Lin Wang[SUP] 1 [/SUP], Lu Ming Yang[SUP] 1 [/SUP], Sheng Fei Pei[SUP] 1 [/SUP], Ying Zhi Chong[SUP] 1 [/SUP], Yu Guo[SUP] 1 [/SUP], Xue Lei Gao[SUP] 1 [/SUP], Qin Yan Tang[SUP] 2 [/SUP], Yue Li[SUP] 1 [/SUP], Fu Min Feng[SUP] 1 2 [/SUP]



Affiliations

Abstract

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), p < .001). Elevated SAA was associated with an increased composite poor outcome in COVID-19 (SMD = 1.06, 95% CI = (0.39, 1.72), p = .002). An elevated LDH was associated with a composite poor outcome (SMD = 1.18, 95% CI = (1.00, 1.36), p < .001). Patients with a composite poor outcome had a higher DD level (SMD = 0.91, 95% CI = (0.79, 1.02), p < .001). This meta-analysis showed that elevated serum CRP, SAA, LDH, and DD were associated with a poor outcome in COVID-19.

Keywords: COVID-19; SARS-CoV-2; biomarkers; meta-analysis; poor outcome.
 
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