Association of inflammatory markers with the severity of COVID-19: A meta-analysis
•Monitoring the severity of COVID-19 is imperative to reduce the poor outcome.•An overview of the association of inflammatory markers with severity of COVID-19.•CRP, PCT, IL-6, ESR, SAA, and serum ferritin are indicators for severity of COVID-19.•Measurement of inflammatory markers assists to monito...
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| Published in | International journal of infectious diseases Vol. 96; pp. 467 - 474 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Canada
Elsevier Ltd
01.07.2020
The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases Elsevier |
| Subjects | |
| Online Access | Get full text |
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| Abstract | •Monitoring the severity of COVID-19 is imperative to reduce the poor outcome.•An overview of the association of inflammatory markers with severity of COVID-19.•CRP, PCT, IL-6, ESR, SAA, and serum ferritin are indicators for severity of COVID-19.•Measurement of inflammatory markers assists to monitor the severity of COVID-19.
Studies reported associations of inflammatory markers with the severity of COVID-19, but conclusions were inconsistent. We aimed to provide an overview of the association of inflammatory markers with the severity of COVID-19.
We searched PubMed, Embase, Cochrane Library, Wanfang and China National Knowledge Infrastructure (CNKI) database until March 20, 2020. Weighted mean difference (WMD) and 95% confidence intervals (CIs) were pooled using random or fixed-effects models.
A total of 16 studies comprising 3962 patients with COVID-19 were included in our analysis. Random-effect results demonstrated that patients with COVID-19 in the nonsevere group had lower levels for CRP (WMD = −41.78 mg/l, 95% CI = [−52.43, −31.13], P < 0.001), PCT (WMD = −0.13 ng/ml, 95% CI = [−0.20, −0.05], P < 0.001), IL-6 (WMD = −21.32 ng/l, 95% CI = [−28.34, −14.31], P < 0.001), ESR (WMD = −8 mm/h, 95% CI = [−14, −2], P = 0.005), SAA (WMD = −43.35 μg/ml, 95% CI = [−80.85, −5.85], P = 0.020) and serum ferritin (WMD = −398.80 mg/l, 95% CI = [−625.89, −171.71], P < 0.001), compared with those in the severe group. Moreover, survivors had a lower level of IL-6 than non-survivors (WMD = −4.80 ng/ml, 95% CI = [−5.87, −3.73], P < 0.001). These results were consistent through sensitivity analysis and publication bias assessment.
The meta-analysis highlights the association of inflammatory markers with the severity of COVID-19. Measurement of inflammatory markers might assist clinicians to monitor and evaluate the severity and prognosis of COVID-19. |
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| AbstractList | •Monitoring the severity of COVID-19 is imperative to reduce the poor outcome.•An overview of the association of inflammatory markers with severity of COVID-19.•CRP, PCT, IL-6, ESR, SAA, and serum ferritin are indicators for severity of COVID-19.•Measurement of inflammatory markers assists to monitor the severity of COVID-19.
Studies reported associations of inflammatory markers with the severity of COVID-19, but conclusions were inconsistent. We aimed to provide an overview of the association of inflammatory markers with the severity of COVID-19.
We searched PubMed, Embase, Cochrane Library, Wanfang and China National Knowledge Infrastructure (CNKI) database until March 20, 2020. Weighted mean difference (WMD) and 95% confidence intervals (CIs) were pooled using random or fixed-effects models.
A total of 16 studies comprising 3962 patients with COVID-19 were included in our analysis. Random-effect results demonstrated that patients with COVID-19 in the nonsevere group had lower levels for CRP (WMD = −41.78 mg/l, 95% CI = [−52.43, −31.13], P < 0.001), PCT (WMD = −0.13 ng/ml, 95% CI = [−0.20, −0.05], P < 0.001), IL-6 (WMD = −21.32 ng/l, 95% CI = [−28.34, −14.31], P < 0.001), ESR (WMD = −8 mm/h, 95% CI = [−14, −2], P = 0.005), SAA (WMD = −43.35 μg/ml, 95% CI = [−80.85, −5.85], P = 0.020) and serum ferritin (WMD = −398.80 mg/l, 95% CI = [−625.89, −171.71], P < 0.001), compared with those in the severe group. Moreover, survivors had a lower level of IL-6 than non-survivors (WMD = −4.80 ng/ml, 95% CI = [−5.87, −3.73], P < 0.001). These results were consistent through sensitivity analysis and publication bias assessment.
The meta-analysis highlights the association of inflammatory markers with the severity of COVID-19. Measurement of inflammatory markers might assist clinicians to monitor and evaluate the severity and prognosis of COVID-19. Studies reported associations of inflammatory markers with the severity of COVID-19, but conclusions were inconsistent. We aimed to provide an overview of the association of inflammatory markers with the severity of COVID-19. We searched PubMed, Embase, Cochrane Library, Wanfang and China National Knowledge Infrastructure (CNKI) database until March 20, 2020. Weighted mean difference (WMD) and 95% confidence intervals (CIs) were pooled using random or fixed-effects models. A total of 16 studies comprising 3962 patients with COVID-19 were included in our analysis. Random-effect results demonstrated that patients with COVID-19 in the nonsevere group had lower levels for CRP (WMD = -41.78 mg/l, 95% CI = [-52.43, -31.13], P < 0.001), PCT (WMD = -0.13 ng/ml, 95% CI = [-0.20, -0.05], P < 0.001), IL-6 (WMD = -21.32 ng/l, 95% CI = [-28.34, -14.31], P < 0.001), ESR (WMD = -8 mm/h, 95% CI = [-14, -2], P = 0.005), SAA (WMD = -43.35 μg/ml, 95% CI = [-80.85, -5.85], P = 0.020) and serum ferritin (WMD = -398.80 mg/l, 95% CI = [-625.89, -171.71], P < 0.001), compared with those in the severe group. Moreover, survivors had a lower level of IL-6 than non-survivors (WMD = -4.80 ng/ml, 95% CI = [-5.87, -3.73], P < 0.001). These results were consistent through sensitivity analysis and publication bias assessment. The meta-analysis highlights the association of inflammatory markers with the severity of COVID-19. Measurement of inflammatory markers might assist clinicians to monitor and evaluate the severity and prognosis of COVID-19. Studies reported associations of inflammatory markers with the severity of COVID-19, but conclusions were inconsistent. We aimed to provide an overview of the association of inflammatory markers with the severity of COVID-19.OBJECTIVESStudies reported associations of inflammatory markers with the severity of COVID-19, but conclusions were inconsistent. We aimed to provide an overview of the association of inflammatory markers with the severity of COVID-19.We searched PubMed, Embase, Cochrane Library, Wanfang and China National Knowledge Infrastructure (CNKI) database until March 20, 2020. Weighted mean difference (WMD) and 95% confidence intervals (CIs) were pooled using random or fixed-effects models.METHODSWe searched PubMed, Embase, Cochrane Library, Wanfang and China National Knowledge Infrastructure (CNKI) database until March 20, 2020. Weighted mean difference (WMD) and 95% confidence intervals (CIs) were pooled using random or fixed-effects models.A total of 16 studies comprising 3962 patients with COVID-19 were included in our analysis. Random-effect results demonstrated that patients with COVID-19 in the nonsevere group had lower levels for CRP (WMD = -41.78 mg/l, 95% CI = [-52.43, -31.13], P < 0.001), PCT (WMD = -0.13 ng/ml, 95% CI = [-0.20, -0.05], P < 0.001), IL-6 (WMD = -21.32 ng/l, 95% CI = [-28.34, -14.31], P < 0.001), ESR (WMD = -8 mm/h, 95% CI = [-14, -2], P = 0.005), SAA (WMD = -43.35 μg/ml, 95% CI = [-80.85, -5.85], P = 0.020) and serum ferritin (WMD = -398.80 mg/l, 95% CI = [-625.89, -171.71], P < 0.001), compared with those in the severe group. Moreover, survivors had a lower level of IL-6 than non-survivors (WMD = -4.80 ng/ml, 95% CI = [-5.87, -3.73], P < 0.001). These results were consistent through sensitivity analysis and publication bias assessment.RESULTSA total of 16 studies comprising 3962 patients with COVID-19 were included in our analysis. Random-effect results demonstrated that patients with COVID-19 in the nonsevere group had lower levels for CRP (WMD = -41.78 mg/l, 95% CI = [-52.43, -31.13], P < 0.001), PCT (WMD = -0.13 ng/ml, 95% CI = [-0.20, -0.05], P < 0.001), IL-6 (WMD = -21.32 ng/l, 95% CI = [-28.34, -14.31], P < 0.001), ESR (WMD = -8 mm/h, 95% CI = [-14, -2], P = 0.005), SAA (WMD = -43.35 μg/ml, 95% CI = [-80.85, -5.85], P = 0.020) and serum ferritin (WMD = -398.80 mg/l, 95% CI = [-625.89, -171.71], P < 0.001), compared with those in the severe group. Moreover, survivors had a lower level of IL-6 than non-survivors (WMD = -4.80 ng/ml, 95% CI = [-5.87, -3.73], P < 0.001). These results were consistent through sensitivity analysis and publication bias assessment.The meta-analysis highlights the association of inflammatory markers with the severity of COVID-19. Measurement of inflammatory markers might assist clinicians to monitor and evaluate the severity and prognosis of COVID-19.CONCLUSIONSThe meta-analysis highlights the association of inflammatory markers with the severity of COVID-19. Measurement of inflammatory markers might assist clinicians to monitor and evaluate the severity and prognosis of COVID-19. Objectives: Studies reported associations of inflammatory markers with the severity of COVID-19, but conclusions were inconsistent. We aimed to provide an overview of the association of inflammatory markers with the severity of COVID-19. Methods: We searched PubMed, Embase, Cochrane Library, Wanfang and China National Knowledge Infrastructure (CNKI) database until March 20, 2020. Weighted mean difference (WMD) and 95% confidence intervals (CIs) were pooled using random or fixed-effects models. Results: A total of 16 studies comprising 3962 patients with COVID-19 were included in our analysis. Random-effect results demonstrated that patients with COVID-19 in the nonsevere group had lower levels for CRP (WMD = −41.78 mg/l, 95% CI = [−52.43, −31.13], P < 0.001), PCT (WMD = −0.13 ng/ml, 95% CI = [−0.20, −0.05], P < 0.001), IL-6 (WMD = −21.32 ng/l, 95% CI = [−28.34, −14.31], P < 0.001), ESR (WMD = −8 mm/h, 95% CI = [−14, −2], P = 0.005), SAA (WMD = −43.35 μg/ml, 95% CI = [−80.85, −5.85], P = 0.020) and serum ferritin (WMD = −398.80 mg/l, 95% CI = [−625.89, −171.71], P < 0.001), compared with those in the severe group. Moreover, survivors had a lower level of IL-6 than non-survivors (WMD = −4.80 ng/ml, 95% CI = [−5.87, −3.73], P < 0.001). These results were consistent through sensitivity analysis and publication bias assessment. Conclusions: The meta-analysis highlights the association of inflammatory markers with the severity of COVID-19. Measurement of inflammatory markers might assist clinicians to monitor and evaluate the severity and prognosis of COVID-19. |
| Author | Xiao, Liang Deng, Guangtong Yin, Mingzhu Huang, Yuzhao Guo, Ying Zeng, Furong Chen, Xiang |
| Author_xml | – sequence: 1 givenname: Furong surname: Zeng fullname: Zeng, Furong organization: Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China – sequence: 2 givenname: Yuzhao surname: Huang fullname: Huang, Yuzhao organization: Department of Orthopaedics, The Third Xiangya Hospital, Central South University, Changsha, Hunan 410008, China – sequence: 3 givenname: Ying surname: Guo fullname: Guo, Ying organization: Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China – sequence: 4 givenname: Mingzhu surname: Yin fullname: Yin, Mingzhu organization: Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China – sequence: 5 givenname: Xiang surname: Chen fullname: Chen, Xiang organization: Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China – sequence: 6 givenname: Liang surname: Xiao fullname: Xiao, Liang email: xiaoliangrick@csu.edu.cn organization: Department of General Surgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China – sequence: 7 givenname: Guangtong surname: Deng fullname: Deng, Guangtong email: dengguangtong@outlook.com organization: Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/32425643$$D View this record in MEDLINE/PubMed |
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| Snippet | •Monitoring the severity of COVID-19 is imperative to reduce the poor outcome.•An overview of the association of inflammatory markers with severity of... Studies reported associations of inflammatory markers with the severity of COVID-19, but conclusions were inconsistent. We aimed to provide an overview of the... Objectives: Studies reported associations of inflammatory markers with the severity of COVID-19, but conclusions were inconsistent. We aimed to provide an... |
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| SubjectTerms | Betacoronavirus Biomarkers - analysis China Coronavirus Infections COVID-19 Humans Inflammation - diagnosis Inflammatory markers Meta-analysis Pandemics Pneumonia, Viral Prognosis SARS-CoV-2 Severity |
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| Title | Association of inflammatory markers with the severity of COVID-19: A meta-analysis |
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