Vol 7, No 2 (2022)
Research paper
Published online: 2022-06-24

open access

Page views 4444
Article views/downloads 340
Get Citation

Connect on Social Media

Connect on Social Media

Systematic review and meta-analysis of serum amyloid a prognostic value in patients with COVID-19

Bartosz Fialek1, Olha Yanvarova2, Michal Pruc3, Aleksandra Gasecka4, Alicja Skrobucha4, Maria Boszko4, Czeslaw Ducki5, Maciej Cyran6, Lukasz Szarpak7
Disaster Emerg Med J 2022;7(2):107-113.

Abstract

INTRODUCTION: This study was designed to assess the levels of human serum amyloid A (SAA) among COVID-19 patients.
MATERIAL AND METHODS: A systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. A comprehensive literature search was performed (PubMed, Web of Science, Scopus, and Cochrane network), and studies comparing SSA levels in: (A) with non-severe vs severe COVID-19; (B) severe vs critical COVID-19 condition; (C) survived vs died due to COVID-19 in-hospital treatment period — were included. Random-effects meta-analyses were performed to obtain pooled estimates.
RESULTS: Thirty studies met the criteria and were included in the meta-analysis. Pooled analysis showed that SAA levels were statistically significantly lover in non-severe group 58.7 ± 53.9 mg/L compared to 154.5 ± 169.6 mg/L for patients with severe condition (MD = –120.29; 95% CI: –135.35 to –105.22; p < 0.001). SAA levels among patients with critical condition were 89.5 ± 90.4 mg/L compared to 195.3 ± 206.2 mg/L (MD = –56.66; 95% CI: –101.81 to –11.51; p = 0.01). SAA levels in patient who survived were 108.7 ± 157.3 mg/L, and 206.8 ± 58.8 mg/L for patients who not survived (MD = –85.04; 95% CI: –145.78 to –24.29; p = 0.006).
CONCLUSIONS: In conclusion, this updated meta-analysis suggests that SAA concentrations are positively correlated with the severity of the COVID-19. Therefore, SAA can be considered a biomarker for predicting the severity and prognosis of COVID-19. Measurement of this parameter might assist clinicians in monitoring and evaluating the severity and prognosis of COVID-19.

Article available in PDF format

View PDF Download PDF file

References

  1. Simonsen L, Viboud C. A comprehensive look at the COVID-19 pandemic death toll. Elife. 2021; 10.
  2. Tan C, Huang Y, Shi F, et al. C-reactive protein correlates with computed tomographic findings and predicts severe COVID-19 early. J Med Virol. 2020; 92(7): 856–862.
  3. Wilson PG, Thompson JC, Shridas P, et al. Serum amyloid A, but not C-reactive protein, stimulates vascular proteoglycan synthesis in a pro-atherogenic manner. Am J Pathol. 2008; 173(6): 1902–1910.
  4. Page M, McKenzie J, Bossuyt P, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021: n71.
  5. Sterne J, Hernán M, Reeves B, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ. 2016(355): i4919.
  6. Sterne JAC, Savović J, Page MJ, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019; 366: l4898.
  7. McGuinness LA, Higgins JPT. Risk-of-bias visualization (robvis): an R package and shiny web app for visualizing risk-of-bias assessments. Res Synth Methods. 2021; 12(1): 55–61.
  8. Welton NJ, White IR, Lu G, et al. The interpretation of random-effects meta-analysis in decision models. Med Decis Making. 2005; 25(6): 646–654.
  9. Egger M, Davey Smith G, Schneider M, et al. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997; 315(7109): 629–634.
  10. Abdelhakam DA, Badr FM, Abd El Monem Teama M, et al. Serum amyloid A, ferritin and carcinoembryonic antigen as biomarkers of severity in patients with COVID-19. Biomed Rep. 2022; 16(2): 13.
  11. Bhatraju PK, Morrell ED, Zelnick L, et al. Comparison of host endothelial, epithelial and inflammatory response in ICU patients with and without COVID-19: a prospective observational cohort study. Crit Care. 2021; 25(1): 148.
  12. Chen R, Sang L, Jiang M, et al. Medical Treatment Expert Group for COVID-19. Longitudinal hematologic and immunologic variations associated with the progression of COVID-19 patients in China. J Allergy Clin Immunol. 2020; 146(1): 89–100.
  13. Chen M, Wu Y, Jia W, et al. The predictive value of serum amyloid A and C-reactive protein levels for the severity of coronavirus disease 2019. Am J Transl Res. 2020; 12(8): 4569–4575.
  14. Cheng Li, Yang JZ, Bai WH, et al. Prognostic value of serum amyloid A in patients with COVID-19. Infection. 2020; 48(5): 715–722.
  15. Dong Y, Zhou H, Li M, et al. A novel simple scoring model for predicting severity of patients with SARS-CoV-2 infection. Transbound Emerg Dis. 2020; 67(6): 2823–2829.
  16. Fu J, Huang PP, Zhang S, et al. The value of serum amyloid A for predicting the severity and recovery of COVID-19. Exp Ther Med. 2020; 20(4): 3571–3577.
  17. Gong J, Ou J, Qiu X, et al. A tool for early prediction of severe coronavirus disease 2019 (COVID-19): a multicenter study using the risk nomogram in Wuhan and Guangdong, China. Clin Infect Dis. 2020; 71(15): 833–840.
  18. Haroun RAH, Osman WH, Eessa AM. Interferon-γ-induced protein 10 (IP-10) and serum amyloid A (SAA) are excellent biomarkers for the prediction of COVID-19 progression and severity. Life Sci. 2021; 269: 119019.
  19. Li L, Chen C. Contribution of acute-phase reaction proteins to the diagnosis and treatment of 2019 novel coronavirus disease (COVID-19). Epidemiol Infect. 2020; 148: e164.
  20. Li H, Xiang X, Ren H, et al. Serum Amyloid A is a biomarker of severe Coronavirus Disease and poor prognosis. J Infect. 2020; 80(6): 646–655.
  21. Liu SL, Wang SY, Sun YF, et al. Expressions of SAA, CRP, and FERR in different severities of COVID-19. Eur Rev Med Pharmacol Sci. 2020; 24(21): 11386–11394.
  22. Liu Q, Dai Y, Feng M, et al. Associations between serum amyloid A, interleukin-6, and COVID-19: A cross-sectional study. J Clin Lab Anal. 2020; 34(10): e23527.
  23. Liu J, Li S, Liu J, et al. Longitudinal characteristics of lymphocyte responses and cytokine profiles in the peripheral blood of SARS-CoV-2 infected patients. EBioMedicine. 2020; 55: 102763.
  24. Liu J, Tu C, Zhu M, et al. The clinical course and prognostic factors of severe COVID-19 in Wuhan, China: A retrospective case-control study. Medicine (Baltimore). 2021; 100(8): e23996.
  25. Liu N, Long H, Sun J, et al. New laboratory evidence for the association between endothelial dysfunction and COVID-19 disease progression. J Med Virol. 2022; 94(7): 3112–3120.
  26. Ma KL, Liu ZH, Cao CF, et al. COVID-19 myocarditis and severity factors: an adult cohort study. .
  27. Mo XN, Su ZQ, Lei CL, et al. Serum amyloid A is a predictor for prognosis of COVID-19. Respirology. 2020; 25(7): 764–765.
  28. Tufa A, Gebremariam T, Manyazewal T, et al. Cytokine and chemokine profile in patients hospitalized with COVID-19: A comparative study. [preprint]. 2022.
  29. Wang D, Li R, Wang J, et al. Correlation analysis between disease severity and clinical and biochemical characteristics of 143 cases of COVID-19 in Wuhan, China: a descriptive study. BMC Infect Dis. 2020; 20(1): 519.
  30. Wang R, Pan M, Zhang X, et al. Epidemiological and clinical features of 125 hospitalized patients with COVID-19 in Fuyang, Anhui, China. Int J Infect Dis. 2020; 95: 421–428.
  31. Wang Q, Cheng J, Shang J, et al. Clinical value of laboratory indicators for predicting disease progression and death in patients with COVID-19: a retrospective cohort study. BMJ Open. 2021; 11(10): e043790.
  32. Xia X, Wen M, Zhan S, et al. [An increased neutrophil/lymphocyte ratio is an early warning signal of severe COVID-19]. Nan Fang Yi Ke Da Xue Xue Bao. 2020; 40(3): 333–336.
  33. Xu Bo, Fan CY, Wang AL, et al. Suppressed T cell-mediated immunity in patients with COVID-19: A clinical retrospective study in Wuhan, China. J Infect. 2020; 81(1): e51–e60.
  34. Yang R, Gui X, Gao S, et al. Clinical progression and changes of chest CT findings among asymptomatic and pre-symptomatic patients with SARS-CoV-2 infection in Wuhan, China. Expert Rev Respir Med. 2021; 15(3): 411–417.
  35. Yu Y, Liu T, Shao L, et al. Novel biomarkers for the prediction of COVID-19 progression a retrospective, multi-center cohort study. Virulence. 2020; 11(1): 1569–1581.
  36. Zeng Z, Hong XY, Li Y, et al. Serum-soluble ST2 as a novel biomarker reflecting inflammatory status and illness severity in patients with COVID-19. Biomark Med. 2020; 14(17): 1619–1629.
  37. Zhang JJ, Dong X, Cao YY, et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy. 2020; 75(7): 1730–1741.
  38. Zhao K, Huang J, Dai D, et al. Serum iron level as a potential predictor of coronavirus disease 2019 severity and mortality: a retrospective study. Open Forum Infect Dis. 2020; 7(7): ofaa250.
  39. Zhou J, Xu XP, Xu F, et al. Clinical symptoms and psychological changes of patients with COVID-19 in Jiangxi Province. [preprint]. .
  40. Khan M, Khan H, Khan S, et al. Epidemiological and clinical characteristics of coronavirus disease (COVID-19) cases at a screening clinic during the early outbreak period: a single-centre study. J Med Microbiol. 2020; 69(8): 1114–1123.
  41. Zhou Y, Yang Q, Chi J, et al. Comorbidities and the risk of severe or fatal outcomes associated with coronavirus disease 2019: A systematic review and meta-analysis. Int J Infect Dis. 2020; 99: 47–56.
  42. Zeng F, Huang Y, Guo Y, et al. Association of inflammatory markers with the severity of COVID-19: a meta-analysis. Int J Infect Dis. 2020; 96: 467–474.
  43. Mahat RK, Panda S, Rathore V, et al. The dynamics of inflammatory markers in coronavirus disease-2019 (COVID-19) patients: A systematic review and meta-analysis. Clin Epidemiol Glob Health. 2021; 11: 100727.
  44. Li Y, Xiaojing He, Zhuanyun Li, et al. Prognostic value of serum amyloid A in COVID-19: A meta-analysis. Medicine (Baltimore). 2022; 101(7): e28880.
  45. Wang L, Yang LuM, Pei SF, et al. CRP, SAA, LDH, and DD predict poor prognosis of coronavirus disease (COVID-19): a meta-analysis from 7739 patients. Scand J Clin Lab Invest. 2021; 81(8): 679–686.
  46. Zhang D, Huang WJ, Lan MQ, et al. Association between serum amyloid A levels and predicting disase severity in COVID-19 patients: a systematic review and meta-analysis. Eur Rev Med Pharmacol Sci. 2021; 25(13): 4627–4638.
  47. Zinellu A, Paliogiannis P, Carru C, et al. Serum amyloid A concentrations, COVID-19 severity and mortality: an updated systematic review and meta-analysis. Int J Infect Dis. 2021; 105: 668–674.



Disaster and Emergency Medicine Journal