{Reference Type}: Journal Article
{Title}: Serum amyloid A concentrations, COVID-19 severity and mortality: An updated systematic review and meta-analysis.
{Author}: Zinellu A;Paliogiannis P;Carru C;Mangoni AA;
{Journal}: Int J Infect Dis
{Volume}: 105
{Issue}: 0
{Year}: Apr 2021
{Factor}: 12.074
{DOI}: 10.1016/j.ijid.2021.03.025
{Abstract}: <B>OBJECTIVE: </B>An excessive inflammatory response in patients with coronavirus disease 2019 (COVID-19) is associated with high disease severity and mortality. Specific acute phase reactants might be useful for risk stratification. A systematic review and meta-analysis was conducted of studies on serum amyloid A (SAA) in patients with COVID-19.<BR><B>METHODS: </B>The PubMed, Web of Science, and Scopus databases were searched, covering the period January 2020 to December 2020, for studies reporting SAA concentrations, COVID-19 severity, and survival status.<BR><B>RESULTS: </B>Nineteen studies involving 5617 COVID-19 patients were included in the meta-analysis. Pooled results showed that SAA concentrations were significantly higher in patients with severe disease and non-survivors (standard mean difference (SMD) 1.20, 95% confidence interval 0.91-1.49, P < 0.001). Extreme between-study heterogeneity was observed (I2 = 92.4%, P < 0.001). In the sensitivity analysis, the effect size was not significantly affected when each study was removed in turn (range 1.10-1.29). The Begg test (P = 0.030), but not the Egger test (P = 0.385), revealed the presence of publication bias. Pooled SMD values were significantly and positively associated with sex (t = 2.20, P = 0.047) and aspartate aminotransferase (t = 3.44, P = 0.014).<BR><B>CONCLUSIONS: </B>SAA concentrations were significantly and positively associated with higher COVID-19 severity and mortality. This acute phase reactant might assist with risk stratification and monitoring in this group.