Systematic review and meta-analysis of serum amyloid A prognostic value in patients with COVID-19

INTRODUCTION: This study was designed to assess the levels of human serum amyloid A (SAA) among COVID-19 patients. MATERIAL AND METHODS: A systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. A comprehensive literature search was performed (PubMed, Web of Science, Scopus, and Cochrane network), and studies comparing SSA levels in: (A) with non-severe vs severe COVID-19; (B) severe vs critical COVID-19 condition; (C) survived vs died due to COVID-19 in-hospital treatment period - were included. Random-effects meta-analyses were performed to obtain pooled estimates. RESULTS: Thirty studies met the criteria and were included in the meta-analysis. Pooled analysis showed that SAA levels were statistically significantly lover in non-severe group 58.7 ± 53.9 mg/L compared to 154.5 ± 169.6 mg/L for patients with severe condition (MD = -120.29; 95% CI: -135.35 to -105.22; p < 0.001). SAA levels among patients with critical condition were 89.5 ± 90.4 mg/L compared to 195.3 ± 206.2 mg/L (MD = -56.66; 95% CI: -101.81 to -11.51; p = 0.01). SAA levels in patient who survived were 108.7 ± 157.3 mg/L, and 206.8 ± 58.8 mg/L for patients who not survived (MD = -85.04; 95% CI: -145.78 to -24.29; p = 0.006). CONCLUSIONS: In conclusion, this updated meta-analysis suggests that SAA concentrations are positively correlated with the severity of the COVID-19. Therefore, SAA can be considered a biomarker for predicting the severity and prognosis of COVID-19. Measurement of this parameter might assist clinicians in monitoring and evaluating the severity and prognosis of COVID-19.