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Ischemic modified albumin and thiol levels in Coronavirus disease 19: a systematic review and meta-analysis

Asma Mousavi1,2, Shayan Shojaei1,2, Peyvand Parhizkar1

  • 1School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Diagnostic and Prognostic Research
|June 23, 2025
PubMed

Insights

Elevated ischemic-modified albumin (IMA) and reduced thiol levels are linked to COVID-19 severity. These oxidative stress markers may help predict patient prognosis and outcomes in the ongoing pandemic.

Area of Science:

  • Biochemistry
  • Clinical Medicine
  • Epidemiology

Background:

  • The COVID-19 pandemic presents a substantial global health challenge.
  • Identifying prognostic markers is crucial for improving patient outcomes by mitigating morbidity and mortality.
  • Oxidative stress indicators, such as ischemic-modified albumin (IMA) and thiol levels, are implicated in disease pathogenesis.

Purpose of the Study:

  • To systematically review and meta-analyze the association between IMA and thiol levels in COVID-19 patients.
  • To evaluate the relationship between these oxidative stress markers and COVID-19 disease severity and mortality.

Main Methods:

  • A comprehensive literature search was conducted across major scientific databases (PubMed, Scopus, Embase, Web of Science).
  • Original studies assessing IMA and thiol levels in COVID-19 patients were included.
  • Random effect meta-analysis was used to calculate standardized mean differences (SMD) and confidence intervals (CI).

Main Results:

  • Sixteen studies involving 2010 COVID-19 patients and 982 controls were analyzed.
  • COVID-19 diagnosis correlated with significantly elevated IMA levels (Hedges's g = 1.02) and reduced total thiol levels (Hedges's g = -1.08).
  • Subgroup analyses indicated lower total and native thiol levels in severe and critical COVID-19 cases, with higher IMA levels across moderate to critical disease stages.

Conclusions:

  • Elevated IMA and diminished thiol levels show potential as novel prognostic markers for COVID-19 severity.
  • These findings suggest oxidative imbalance plays a significant role in COVID-19 pathogenesis.
  • Further research should explore therapeutic strategies targeting oxidative stress in COVID-19 patients.
Abstract

Keywords:
COVID-19Ischemic modified albuminMeta-analysisThiol

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