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Elevated De Ritis Ratio Is Associated With Poor Prognosis in COVID-19: A Systematic Review and Meta-Analysis

Raymond Pranata1, Ian Huang1,2, Michael Anthonius Lim1

  • 1Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia.

Frontiers in Medicine
|January 10, 2022
PubMed

Insights

An elevated De Ritis ratio (AST/ALT) is linked to worse outcomes in COVID-19 patients. This finding suggests the ratio can help predict prognosis in coronavirus cases.

Area of Science:

  • Medical Diagnostics
  • Infectious Diseases
  • Biomarkers

Background:

  • The De Ritis ratio, or Aspartate aminotransferase/alanine transaminase (AST/ALT) ratio, is a potential indicator of liver function and cellular damage.
  • Its association with prognosis in coronavirus 2019 (COVID-19) patients requires comprehensive evaluation.

Approach:

  • A systematic literature review and meta-analysis was conducted using data from PubMed, Embase, and EuropePMC databases.
  • Eight studies encompassing 4,606 patients were analyzed to assess the relationship between elevated De Ritis ratio and COVID-19 prognosis.
  • Key outcomes included mortality, disease severity, ICU admission, and intubation, with statistical measures like odds ratios and mean differences calculated.

Key Points:

  • Elevated De Ritis ratio was observed in 44% of patients and was significantly higher in those with poor prognosis (mean difference 0.41) and non-survivors (mean difference 0.47).
  • An elevated De Ritis ratio was associated with poor COVID-19 prognosis (OR 3.28), demonstrating a sensitivity of 55% and specificity of 71%.
  • The posterior probability of poor prognosis was 38% with an elevated De Ritis ratio, compared to 17% when not elevated.

Conclusions:

  • The De Ritis ratio serves as a valuable biomarker for predicting poor prognosis in COVID-19 patients.
  • This meta-analysis confirms a significant association between an elevated AST/ALT ratio and adverse outcomes in coronavirus disease.
  • Further research may explore the clinical utility of the De Ritis ratio in managing COVID-19 patients.

Keywords:
De Ritis ratioSARS-CoV-2coronavirus—COVID-19liver enzymetransaminase

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