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Inflammatory and vascular biomarkers in post-COVID-19 syndrome: A systematic review and meta-analysis of over 20 biomarkers |
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| Authors: | Shin Jie Yong Alice Halim Michael Halim Shiliang Liu Mohammed Aljeldah Basim R. Al Shammari Sara Alwarthan Mashael Alhajri Abdulsalam Alawfi Amer Alshengeti Faryal Khamis Jameela Alsalman Abeer N. Alshukairi Nujoud A. Abukhamis Fatimah S. Almaghrabi Souad A. Almuthree Abdulrahman M. Alsulaiman Bashayer M. Alshehail Amal H. Alfaraj Shorouq A. Alhawaj Ranjan K. Mohapatra Ali A. Rabaan |
| Affiliation: | 1. Department of Biological Sciences, School of Medical and Life Sciences, Sunway University, Selangor, Malaysia;2. Shanghai Medical College, Fudan University, Shanghai, China;3. Department of Biomedical Science, School of Science, Engineering and Environment, University of Salford, Greater Manchester, UK;4. 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;5. Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, University of Hafr Al Batin, Hafr Al Batin, Saudi Arabia;6. Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia;7. Department of Pediatrics, College of Medicine, Taibah University, Al-Madinah, Saudi Arabia;8. 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;9. Infection Diseases Unit, Department of Internal Medicine, Royal Hospital, Muscat, Oman;10. Infection Disease Unit, Department of Internal Medicine, Salmaniya Medical Complex, Ministry of Health, Manama, Bahrain;11. Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi College of Medicine, Alfaisal University, Riyadh, Saudi Arabia;12. Molecular Virology Laboratory, East Jeddah Hospital, Jeddah, Saudi Arabia;13. Department of Infectious Disease, King Abdullah Medical City, Makkah, Saudi Arabia;14. Laboratory Department, Almostaqbal Medical Laboratories, Riyadh, Saudi Arabia;15. Pharmacy Practice Department, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia;16. Pediatric Department, Abqaiq General Hospital, First Eastern Health Cluster, Abqaiq, Saudi Arabia;17. Department of Nursing Model of Care, Nephrology Dialysis & Transplant Unit, Qatif Central Hospital, Qatif, Saudi Arabia;18. Department of Chemistry, Government College of Engineering, Keonjhar, India;19. College of Medicine, Alfaisal University, Riyadh, Saudi Arabia |
| 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. |
| Keywords: | biomarkers inflammation long-COVID post-COVID-19 syndrome SARS-CoV-2 vascular disorders |