PDF(Pubmed)
Abstract：
With COVID-19 still hovering around and threatening the lives of many at-risk patients, an effective, quick, and inexpensive prognostic method is required. Few studies have shown fibrinogen to albumin ratio (FAR) and C-reactive protein to albumin ratio (CAR) to be promising as prognostic markers for COVID-19 disease. However, their implications remain unclear. This meta-analysis aimed to elucidate the prognostic role of FAR and CAR in COVID-19 disease. A systematic literature search was undertaken using PubMed and Embase till April 2022. Inverse variance standardised mean difference (SMD) was calculated to report the overall effect size using random effect models. The generic inverse variance random-effects method was used to pool the area under the curve (AUC) values. All statistical analyses were performed on Revman and MedCalc Software. A total of 23 studies were included. COVID-19 non-survivors had a higher CAR on admission compared with survivors (SMD = 1.79 [1.04, 2.55]; p < 0.00001; I2 = 97%) and patients with a severe COVID-19 infection had a higher CAR on admission than non-severe patients (SMD = 1.21 [0.54, 1.89]; p = 0.0004; I2 = 97%). Similarly, higher mean FAR values on admission were significantly associated with COVID-19 mortality (SMD = 0.55 [0.32, 0.78]; p < 0.00001; I2 = 82%). However, no significant association was found between mean FAR on admission and COVID-19 severity (SMD = 0.54 [-0.09, 1.18]; p = 0.09; I2 = 91%). The pooled AUC values found that CAR had a good discriminatory-power to predict COVID-19 severity (AUC = 0.81 [0.75, 0.86]; p < 0.00001; I2 = 80%) and mortality (AUC = 0.81 [0.74, 0.87]; p < 0.00001; I2 = 86%). FAR had a fair discriminatory-power to predict COVID-19 severity (AUC = 0.73 [0.64, 0.82]; p < 0.00001; I2 = 89%). Overall, CAR was a good predictor of both severity and mortality associated with COVID-19 infection. Similarly, FAR was a satisfactory predictor of COVID-19 mortality but not severity.
摘要：
COVID-19仍然徘徊，威胁着许多高危患者的生命，一个有效的,快,并且需要廉价的预后方法。很少有研究表明纤维蛋白原与白蛋白之比（FAR）和C反应蛋白与白蛋白之比（CAR）有望作为COVID-19疾病的预后标志物。然而,其含义尚不清楚。这项荟萃分析旨在阐明FAR和CAR在COVID-19疾病中的预后作用。使用PubMed和Embase进行了系统的文献检索，直到2022年4月。使用随机效应模型计算逆方差标准化平均差(SMD)以报告总体效应大小。通用逆方差随机效应方法用于汇集曲线下面积(AUC)值。所有统计分析均在Revman和MedCalc软件上进行。共纳入23项研究。非COVID-19幸存者入院时的CAR高于幸存者(SMD=1.79[1.04,2.55]；p<0.00001；I2=97%)，重度COVID-19感染患者入院时的CAR高于非重度患者(SMD=1.21[0.54,1.89]；p=0.0004；I2=97%)。同样，入院时更高的平均FAR值与COVID-19死亡率显著相关(SMD=0.55[0.32,0.78];p<0.00001;I2=82%).然而,入院时平均FAR与COVID-19严重程度无显著关联(SMD=0.54[-0.09,1.18];p=0.09;I2=91%).汇总的AUC值发现，CAR对预测COVID-19的严重程度(AUC=0.81[0.75，0.86]；p<0.00001；I2=80%)和死亡率(AUC=0.81[0.74，0.87]；p<0.00001；I2=86%)具有良好的判别力。FAR对预测COVID-19严重程度具有公平的判别能力(AUC=0.73[0.64,0.82]；p<0.00001；I2=89%)。总的来说,CAR是与COVID-19感染相关的严重程度和死亡率的良好预测指标。同样，FAR是COVID-19死亡率的令人满意的预测因子，但不是严重程度。
