Prognostic value of albumin-to-globulin ratio in COVID-19 patients: A systematic review and meta-analysis

• Published in: Heliyon Vol. 8; no. 5; p. e09457
• Main Authors: Ulloque-Badaracco, Juan R., Mosquera-Rojas, Melany D., Hernandez-Bustamante, Enrique A., Alarcón-Braga, Esteban A., Herrera-Añazco, Percy, Benites-Zapata, Vicente A.
• Format: Journal Article Web Resource
• Language: English
• Published: England Elsevier Ltd 01.05.2022; Elsevier BV; Elsevier
• Subjects: Albumin; COVID-19; Globulin; Prognosis; Review; COVID-19; Albumin; Prognosis; Globulin
• ISSN: 2405-8440; 2405-8440
• DOI: 10.1016/j.heliyon.2022.e09457

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; I2 = 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; I2 = 79%). In the sensitivity analysis, we only included studies with low risk of bias, which decreased the heterogeneity for both outcomes (severity, I2 = 20%; mortality, I2 = 5%). Low AGR values upon hospital admission were found in COVID-19 patients with a worse prognosis. Albumin, COVID-19, Globulin, Prognosis.