C-reactive protein-to-albumin ratio and clinical outcomes in COVID-19 patients: A systematic review and meta-analysis

C-reactive protein-to-albumin ratio and clinical outcomes in COVID-19 patients: A systematic review and meta-analysis

C-reactive protein-to-albumin ratio (CAR) is an independent risk factor in cardiovascular, cerebrovascular, and infectious diseases. Through this study, we investigated the CAR values with respect to the severity and mortality of COVID-19 patients. We performed a systematic review and meta-analysis...

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Published in:Tropical medicine and infectious disease Vol. 7; no. 8; pp. 1 - 14
Main Authors: Hernan J Zavalaga-Zegarra, Juan J Palomino-Gutierrez, Juan R Ulloque-Badaracco, Melany D Mosquera-Rojas, Enrique A Hernandez-Bustamante, Esteban A Alarcon-Braga, Vicente A Benites-Zapata, Percy Herrera-Anazco, Adrian V Hernandez
Format: Journal Article
Language:English
Published: Basel, Switzerland MDPI 16-08-2022
MDPI AG
Subjects:
albumin
Bias
Biomarkers
C-reactive protein
Care
Clinical outcomes
Collaboration
Coronaviruses
COVID-19
COVID-19 (Disease)
Disease transmission
Medical research
Meta-analysis
Mortality
Pandemics
Patients
Population
Prevention
Proteins
Sensitivity analysis
Severe acute respiratory syndrome coronavirus 2
Statistical analysis
Systematic Review
Treatment
United States > US
COVID-19
meta-analysis
C-reactive protein
albumin
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Summary:C-reactive protein-to-albumin ratio (CAR) is an independent risk factor in cardiovascular, cerebrovascular, and infectious diseases. Through this study, we investigated the CAR values with respect to the severity and mortality of COVID-19 patients. We performed a systematic review and meta-analysis to retrieve studies that evaluated CAR values upon hospital admission in relation to the severity or mortality of COVID-19 patients. We adopted a random-effect model to calculate the pooled mean difference (MD) and their 95% confidence intervals (CI). Quality assessment was appraised using a Newcastle-Ottawa scale and publication bias was assessed using the Begg-test and funnel plot. We equally performed a subgroup analysis using study location and a sensitivity analysis only with studies with low risk of bias. We analyzed 32 studies (n = 12445). Severe COVID-19 patients had higher on-admission CAR values than non-severe COVID-19 patients (MD: 1.69; 95% CI: 1.35-2.03; 'p' < 0.001; I2 = 89%). Non-survivor patients with COVID-19 had higher CAR values than survivor patients (MD: 2.59; 95% CI: 1.95-3.23; 'p' < 0.001; I2 = 92%). In sensitivity analysis, the relationship remained with a decreasing of heterogeneity for severity (MD: 1.22; 95% CI: 1.03-1.40; 'p' < 0.001; I2 = 13%) and for mortality (MD: 2.99; 95% CI: 2.47-3.51; 'p' < 0.001; I2 = 0%). High CAR values were found in COVID-19 patients who developed severe disease or died.
Bibliography:Tropical Medicine and Infectious Disease, Vol. 7, No. 8, Aug 2022, 1-14
Informit, Melbourne (Vic)
ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
ObjectType-Review-3
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ISSN:2414-6366
2414-6366
DOI:10.3390/tropicalmed7080186