■过度的全身促炎状态会增加2019年冠状病毒病患者的严重疾病和死亡风险(COVID-19)。然而,对于特定的炎症生物标志物是否可以增强该组的风险分层,目前还不确定.我们进行了系统评价和荟萃分析,以调查来自常规血液学参数的系统性炎症的新兴生物标志物。全身炎症指数(SII),在不同疾病严重程度和生存状态的COVID-19患者中。
■在PubMed进行了系统的文献检索,WebofScience,还有Scopus,在2019年12月1日至2023年3月15日之间。使用JoannaBriggs研究所关键评估清单和建议等级来评估偏倚和证据确定性的风险,评估,发展与评价,分别(PROSPERO注册号:CRD42023420517)。
■在39项研究中,与具有非严重疾病或生存状态的患者相比,具有严重疾病或非生存状态的患者在入院时的SII值显著较高(标准均差(SMD)=0.91,95%CI0.75~1.06,p<0.001;中等证据确定性).在10项报告比值比的研究中,SII也与严重疾病或死亡的风险显著相关(1.007,95%CI1.001至1.014,p=0.032;证据的确定性非常低),在6项报告风险比的研究中,SII与严重疾病或死亡的风险显著相关(1.99,95%CI1.01至3.92,p=0.047;证据的确定性非常低)。汇集灵敏度,特异性,严重疾病或死亡率的曲线下面积为0.71(95%CI0.67至0.75),0.71(95%CI0.64至0.77),和0.77(95%CI0.73至0.80),分别。在元回归中,在SMD和白蛋白之间观察到显着的相关性,乳酸脱氢酶,肌酐,和D-二聚体。
■我们的系统评价和荟萃分析表明,入院时的SII与COVID-19患者的严重疾病和死亡率显着相关。因此,这种源自常规血液学参数的炎症生物标志物有助于本组的早期风险分层.
■https://www.crd.约克。AC.英国/PROSPERO,标识符CRD42023420517。
An excessive systemic pro-inflammatory state increases the risk of severe disease and mortality in patients with coronavirus disease 2019 (COVID-19). However, there is uncertainty regarding whether specific biomarkers of inflammation can enhance risk stratification in this group. We conducted a systematic
review and meta-analysis to investigate an emerging biomarker of systemic inflammation derived from routine hematological parameters, the systemic inflammation index (SII), in COVID-19 patients with different disease severity and survival status.
A systematic literature search was conducted in PubMed, Web of Science, and Scopus, between the 1st of December 2019 and the 15th of March 2023. Risk of bias and certainty of evidence were assessed using the Joanna Briggs Institute Critical Appraisal Checklist and the Grades of Recommendation, Assessment, Development and Evaluation, respectively (PROSPERO registration number: CRD42023420517).
In 39 studies, patients with a severe disease or non-survivor status had significantly higher SII values on admission compared to patients with a non-severe disease or survivor status (standard mean difference (SMD)=0.91, 95% CI 0.75 to 1.06, p<0.001; moderate certainty of evidence). The SII was also significantly associated with the risk of severe disease or death in 10 studies reporting odds ratios (1.007, 95% CI 1.001 to 1.014, p=0.032; very low certainty of evidence) and in six studies reporting hazard ratios (1.99, 95% CI 1.01 to 3.92, p=0.047; very low certainty of evidence). Pooled sensitivity, specificity, and area under the curve for severe disease or mortality were 0.71 (95% CI 0.67 to 0.75), 0.71 (95% CI 0.64 to 0.77), and 0.77 (95% CI 0.73 to 0.80), respectively. In meta-regression, significant correlations were observed between the SMD and albumin, lactate dehydrogenase, creatinine, and D-dimer.
Our systematic
review and meta-analysis has shown that the SII on admission is significantly associated with severe disease and mortality in patients with COVID-19. Therefore, this inflammatory biomarker derived from routine haematological parameters can be helpful for early risk stratification in this group.
https://www.crd.york.ac.uk/PROSPERO, identifier CRD42023420517.