背景:随着2019年冠状病毒病(COVID-19)的出现,已经确定了几种血液生物标志物,包括内皮生物标志物syndecan-1,一种表面蛋白聚糖。在目前的系统评价和荟萃分析中,我们旨在评估syndecan-1在COVID-19中的诊断和预后作用。
方法:PubMed,Embase,Scopus,和WebofScience,作为国际数据库,搜索了相关研究,测量COVID-19患者的血液中syndecan-1水平,COVID-19疗养院,和健康的对照受试者,不同严重程度的COVID-19患者和/或预后较差的COVID-19患者。使用STATA进行随机效应荟萃分析,以计算COVID-19患者与健康对照组或COVID-19康复患者与对照组之间的标准化平均差异(SMD)和95%置信区间(CI)。
结果:经过标题/摘要和全文筛选,17项研究纳入最终审查。COVID-19患者syndecan-1水平与健康对照组比较的Meta分析显示,COVID-19患者syndecan-1水平显著升高(SMD1.53,95%CI0.66~2.41,P<0.01)。相比之下,COVID-19恢复期患者与非恢复期患者无显著差异(SMD0.08,95%CI-0.63至0.78,P=0.83)。关于疾病的严重程度,两项研究报道,更严重的疾病与syndecan-1水平升高相关.此外,与存活者相比,死于COVID-19的患者的syndecan-1水平更高(SMD1.22,95%CI0.10~2.33,P=0.03).
结论:循环syndecan-1水平可用作COVID-19内皮功能障碍的生物标志物,因为它在COVID-19患者中升高,而在更严重的疾病中升高。需要进一步的更大的研究来证实这些发现,并进一步启发syndecan-1在临床环境中的作用。
BACKGROUND: With the emergence of coronavirus disease of 2019 (COVID-19), several blood biomarkers have been identified, including the endothelial biomarker syndecan-1, a surface proteoglycan. In the current systematic
review and meta-analysis, we aimed to assess the diagnostic and prognostic role of syndecan-1 in COVID-19.
METHODS: PubMed, Embase, Scopus, and Web of Science, as international databases, were searched for relevant studies measuring blood syndecan-1 levels in COVID-19 patients, COVID-19 convalescents, and healthy control subjects, in patients with different COVID-19 severities and/or in COVID-19 patients with poor outcomes. Random-effect meta-analysis was performed using STATA to calculate the standardized mean difference (SMD) and 95% confidence interval (CI) for the comparison between COVID-19 patients and healthy control subjects or COVID-19 convalescents and controls.
RESULTS: After screening by title/abstract and full text, 17 studies were included in the final
review. Meta-analysis of syndecan-1 levels in COVID-19 compared with healthy control subjects revealed that patients with COVID-19 had significantly higher syndecan-1 levels (SMD 1.53, 95% CI 0.66 to 2.41, P < 0.01). In contrast, COVID-19 convalescent patients did not show significant difference with non-convalescents (SMD 0.08, 95% CI -0.63 to 0.78, P = 0.83). Regarding disease severity, two studies reported that more severe forms of the disease were associated with increased syndecan-1 levels. Moreover, patients who died from COVID-19 had higher syndecan-1 levels compared with survivors (SMD 1.22, 95% CI 0.10 to 2.33, P = 0.03).
CONCLUSIONS: Circulating syndecan-1 level can be used as a biomarker of endothelial dysfunction in COVID-19, as it was increased in COVID-19 patients and was higher in more severe instances of the disease. Further larger studies are needed to confirm these findings and further enlighten the role of syndecan-1 in clinical settings.