Biomarkers of cytokine storm as red flags for severe and fatal COVID-19 cases: A living systematic review and meta-analysis.

Autor: Melo AKG; Division of Rheumatology, Department of Clinical Medicine, Hospital Universitário Lauro Wanderley, Universidade Federal da Paraíba, João Pessoa, PB, Brazil.; Evidence-Based Health Program, Universidade Federal de São Paulo, São Paulo, SP, Brazil., Milby KM; Evidence-Based Health Program, Universidade Federal de São Paulo, São Paulo, SP, Brazil., Caparroz ALMA; Evidence-Based Health Program, Universidade Federal de São Paulo, São Paulo, SP, Brazil.; Department of Pediatric Rheumatology, Hospital de Base, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP, Brazil., Pinto ACPN; Evidence-Based Health Program, Universidade Federal de São Paulo, São Paulo, SP, Brazil.; Department of Biological and Health Sciences, Universidade Federal do Amapá, Macapá, AP, Brazil.; Fulbright Alumna at University of Pittsburgh, Pittsburgh, PA, United States of America., Santos RRP; Evidence-Based Health Program, Universidade Federal de São Paulo, São Paulo, SP, Brazil.; Department of Data Science, Synova Health, Campinas, SP, Brazil., Rocha AP; Evidence-Based Health Program, Universidade Federal de São Paulo, São Paulo, SP, Brazil., Ferreira GA; Department of Lokomotor System, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil., Souza VA; Department of Clinical Medicine, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil., Valadares LDA; Department of Rheumatology, Hospital Getúlio Vargas de Pernambuco, Recife, PE, Brazil., Vieira RMRA; Department of Clinical Medicine, Universidade Estadual do Ceará, Fortaleza, CE, Brazil.; Department of Clinical Medicine, Universidade de Fortaleza, Fortaleza, CE, Brazil., Pileggi GS; Department of Rheumatology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil., Trevisani VFM; Evidence-Based Health Program, Universidade Federal de São Paulo, São Paulo, SP, Brazil.; Department of Rheumatology, Universidade de Santo Amaro, São Paulo, SP, Brazil.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2021 Jun 29; Vol. 16 (6), pp. e0253894. Date of Electronic Publication: 2021 Jun 29 (Print Publication: 2021).
DOI: 10.1371/journal.pone.0253894
Abstrakt: Objective: To describe the laboratory parameters and biomarkers of the cytokine storm syndrome associated with severe and fatal COVID-19 cases.
Methods: A search with standardized descriptors and synonyms was performed on November 28th, 2020 of the MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, LILACS, and IBECS to identify studies of interest. Grey literature searches and snowballing techniques were additionally utilized to identify yet-unpublished works and related citations. Two review authors independently screened the retrieved titles and abstracts, selected eligible studies for inclusion, extracted data from the included studies, and then assessed the risk of bias using the Newcastle-Ottawa Scale. Eligible studies were those including laboratory parameters-including serum interleukin-6 levels-from mild, moderate, or severe COVID-19 cases. Laboratory parameters, such as interleukin-6, ferritin, hematology, C-Reactive Protein, procalcitonin, lactate dehydrogenase, aspartate aminotransferase, creatinine, and D-dimer, were extracted from the studies. Meta-analyses were conducted using the laboratory data to estimate mean differences with associated 95% confidence intervals.
Data Synthesis: The database search yielded 9,620 records; 40 studies (containing a total of 9,542 patients) were included in the final analysis. Twenty-one studies (n = 4,313) assessed laboratory data related to severe COVID-19 cases, eighteen studies (n = 4,681) assessed predictors for fatal COVID-19 cases and one study (n = 548) assessed laboratory biomarkers related to severe and fatal COVID-19 cases. Lymphopenia, thrombocytopenia, and elevated levels of interleukin-6, ferritin, D-dimer, aspartate aminotransferase, C-Reactive-Protein, procalcitonin, creatinine, neutrophils and leucocytes were associated with severe and fatal COVID-19 cases.
Conclusions: This review points to interleukin-6, ferritin, leukocytes, neutrophils, lymphocytes, platelets, C-Reactive Protein, procalcitonin, lactate dehydrogenase, aspartate aminotransferase, creatinine, and D-dimer as important biomarkers of cytokine storm syndrome. Elevated levels of interleukin-6 and hyperferritinemia should be considered as red flags of systemic inflammation and poor prognosis in COVID-19.
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE
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