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Cystatin C, COVID-19 severity and mortality: a systematic review and meta-analysis

Angelo Zinellu1, Arduino A Mangoni2,3

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

Journal of Nephrology
|August 14, 2021
PubMed

Insights

Higher serum cystatin C levels indicate increased coronavirus disease 19 (COVID-19) severity and mortality risk. This marker aids in stratifying patients and guiding clinical decisions for better COVID-19 management.

Area of Science:

  • Biochemistry
  • Clinical Medicine
  • Epidemiology

Background:

  • Coronavirus disease 19 (COVID-19) poses significant clinical challenges.
  • Markers of renal dysfunction and inflammation, such as cystatin C, may aid in risk stratification for COVID-19 patients.

Purpose of the Study:

  • To systematically review and meta-analyze the association between serum cystatin C concentrations and clinical outcomes in COVID-19 patients.

Main Methods:

  • A systematic literature search was conducted in PubMed, Web of Science, and Scopus (January 2020 - February 2021).
  • Included studies reported serum cystatin C levels, clinical severity, and survival outcomes in hospitalized COVID-19 patients.
  • Meta-analysis and meta-regression were performed on data from 13 studies involving 2510 patients.

Main Results:

  • Higher serum cystatin C concentrations were significantly associated with increased COVID-19 disease severity and non-survivor status (SMD 1.71, p < 0.001).
  • Extreme heterogeneity was noted across studies (I² = 97.5%), but sensitivity analyses confirmed the robustness of the findings.
  • Meta-regression revealed no association between serum cystatin C levels and various demographic or laboratory parameters, including age, sex, or common comorbidities.

Conclusions:

  • Elevated serum cystatin C levels are a strong indicator of higher severity and mortality in COVID-19 patients.
  • Serum cystatin C shows potential as a valuable biomarker for risk stratification and clinical decision-making in COVID-19 management.
Abstract

Keywords:
COVID-19 severityMortalitySerum cystatin C

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