Excessive inflammation and malnutrition are associated with coronavirus disease 2019 (COVID-19) severity and mortality. Combined biomarkers of malnutrition and inflammation, such as serum prealbumin, might be particularly attractive for early risk stratification. We conducted a systematic review and meta-analysis of studies reporting serum prealbumin in patients with COVID-19. We searched PubMed, Web of Science and Scopus, between January and November 2020, for studies reporting data on serum prealbumin, COVID-19 severity, defined as severe illness, prolonged viral load, receiving mechanical ventilation or admitted to intensive care unit (ICU), and mortality. Nineteen studies in 4,616 COVID-19 patients were included in the meta-analysis. Pooled results showed that serum prealbumin concentrations were significantly lower in patients with severe disease and non-survivors (standard mean difference, SMD, −0.92, 95% CI, −1.10 to −0.74, P < 0.001). Extreme heterogeneity was observed ( I 2 = 77.9%; P < 0.001). In sensitivity analysis, the effect size was not significantly affected when each study was in turn removed (range between −0.86 and −0.95). The Begg's ( P = 0.06) and Egger's t -tests ( P = 0.26) did not show publication bias. Pooled SMD values were significantly and negatively associated with age ( t = −2.18, P = 0.045) and C-reactive protein ( t = −3.85, P = 0.002). In our meta-analysis, lower serum prealbumin concentrations were significantly associated with COVID-19 severity and mortality. This combined marker of malnutrition and inflammation might assist with early risk stratification and management in this group.
【저자키워드】 COVID-19, Biomarker, Mortality, disease severity, prealbumin, 【초록키워드】 coronavirus disease, Meta-analysis, Inflammation, intensive care, mechanical ventilation, severity, COVID-19 severity, systematic review, C-reactive protein, heterogeneity, ICU, risk stratification, serum, Viral load, management, Patient, sensitivity analysis, age, Malnutrition, marker, Concentration, severe disease, COVID-19 patient, Web of Science, 95% CI, mean difference, effect size, significantly lower, t -test, SMD, non-survivor, Combined, defined, affected, significantly, conducted, receiving, searched, turn, assist, Egger, patients with COVID-19, with COVID-19, 【제목키워드】 review,