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Serum amyloid A concentrations, COVID-19 severity and mortality: An updated systematic review and meta-analysis

Angelo Zinellu1, Panagiotis Paliogiannis2, Ciriaco Carru3

  • 1Department of Biomedical Sciences, University of Sassari, Sassari, Italy.

International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases
|March 19, 2021
PubMed

Insights

Elevated serum amyloid A (SAA) levels in COVID-19 patients indicate increased disease severity and mortality. This acute phase reactant shows potential for risk stratification and monitoring in coronavirus disease 2019 management.

Area of Science:

  • Clinical Medicine
  • Immunology
  • Infectious Diseases

Background:

  • Excessive inflammatory responses in COVID-19 correlate with severe outcomes and mortality.
  • Acute phase reactants may aid in stratifying patient risk.
  • Serum amyloid A (SAA) is an acute phase reactant investigated for its role in COVID-19.

Purpose of the Study:

  • To systematically review and meta-analyze studies on serum amyloid A (SAA) concentrations in patients with COVID-19.
  • To assess the association between SAA levels and COVID-19 severity and mortality.
  • To evaluate SAA's potential utility in risk stratification for COVID-19 patients.

Main Methods:

  • A systematic search of PubMed, Web of Science, and Scopus databases was performed for studies published between January 2020 and December 2020.
  • Included studies reported SAA concentrations, COVID-19 severity, and survival status.
  • A meta-analysis was conducted on data from 19 studies involving 5617 COVID-19 patients.

Main Results:

  • Pooled analysis revealed significantly higher SAA concentrations in severe COVID-19 cases and non-survivors (SMD 1.20, P < 0.001).
  • High heterogeneity was observed between studies (I² = 92.4%).
  • Sensitivity analysis confirmed the robustness of the effect size, and publication bias was detected via the Begg test (P = 0.030).

Conclusions:

  • SAA concentrations are significantly associated with increased COVID-19 severity and mortality.
  • SAA may serve as a valuable biomarker for risk stratification and patient monitoring in COVID-19.
  • Further research may elucidate the precise role of SAA in the inflammatory cascade of COVID-19.
Abstract

Keywords:
COVID-19Disease severityMortalitySerum amyloid A

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