Inflammatory and vascular biomarkers in post-COVID-19 syndrome: A systematic review and meta-analysis of over 20 biomarkers.

Department of Biological Sciences, School of Medical and Life Sciences, Sunway University, Selangor, Malaysia. Shanghai Medical College, Fudan University, Shanghai, China. Department of Biomedical Science, School of Science, Engineering and Environment, University of Salford, Greater Manchester, UK. Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada. School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada. Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, University of Hafr Al Batin, Hafr Al Batin, Saudi Arabia. Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia. Department of Pediatrics, College of Medicine, Taibah University, Al-Madinah, Saudi Arabia. Department of Infection Prevention and Control, Prince Mohammad Bin Abdulaziz Hospital, National Guard Health Affairs, Al-Madinah, Saudi Arabia. Infection Diseases Unit, Department of Internal Medicine, Royal Hospital, Muscat, Oman. Infection Disease Unit, Department of Internal Medicine, Salmaniya Medical Complex, Ministry of Health, Manama, Bahrain. Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi. College of Medicine, Alfaisal University, Riyadh, Saudi Arabia. Molecular Virology Laboratory, East Jeddah Hospital, Jeddah, Saudi Arabia. Department of Infectious Disease, King Abdullah Medical City, Makkah, Saudi Arabia. Laboratory Department, Almostaqbal Medical Laboratories, Riyadh, Saudi Arabia. Pharmacy Practice Department, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia. Pediatric Department, Abqaiq General Hospital, First Eastern Health Cluster, Abqaiq, Saudi Arabia. Department of Nursing Model of Care, Nephrology Dialysis & Transplant Unit, Qatif Central Hospital, Qatif, Saudi Arabia. Department of Chemistry, Government College of Engineering, Keonjhar, India. Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia. Department of Public Health and Nutrition, The University of Haripur, Haripur, Pakistan.

Reviews in medical virology. 2023;(2):e2424

Abstract

Severe acute respiratory syndrome coronavirus 2 may inflict a post-viral condition known as post-COVID-19 syndrome (PCS) or long-COVID. Studies measuring levels of inflammatory and vascular biomarkers in blood, serum, or plasma of COVID-19 survivors with PCS versus non-PCS controls have produced mixed findings. Our review sought to meta-analyse those studies. A systematic literature search was performed across five databases until 25 June 2022, with an updated search on 1 November 2022. Data analyses were performed with Review Manager and R Studio statistical software. Twenty-four biomarkers from 23 studies were meta-analysed. Higher levels of C-reactive protein (Standardized mean difference (SMD) = 0.20; 95% CI: 0.02-0.39), D-dimer (SMD = 0.27; 95% CI: 0.09-0.46), lactate dehydrogenase (SMD = 0.30; 95% CI: 0.05-0.54), and leukocytes (SMD = 0.34; 95% CI: 0.02-0.66) were found in COVID-19 survivors with PCS than in those without PCS. After sensitivity analyses, lymphocytes (SMD = 0.30; 95% CI: 0.12-0.48) and interleukin-6 (SMD = 0.30; 95% CI: 0.12-0.49) were also significantly higher in PCS than non-PCS cases. No significant differences were noted in the remaining biomarkers investigated (e.g., ferritin, platelets, troponin, and fibrinogen). Subgroup analyses suggested the biomarker changes were mainly driven by PCS cases diagnosed via manifestation of organ abnormalities rather than symptomatic persistence, as well as PCS cases with duration of <6 than ≥6 months. In conclusion, our review pinpointed certain inflammatory and vascular biomarkers associated with PCS, which may shed light on potential new approaches to understanding, diagnosing, and treating PCS.

Methodological quality

Publication Type : Meta-Analysis ; Review

Metadata