Evaluating Biomarkers for Predicting Clinical Outcomes in COVID-19 Patients: A Systematic Review

Abstract

The Coronavirus disease 2019 (COVID-19) is an infectious disease caused by the novel human pathogen severe acute respiratory syndrome coronavirus 2, that resulted in millions of human deaths worldwide. A systematic review was conducted to identify biomarkers associated with the clinical progression of COVID-19. The search was conducted across four databases (ProQuest, PubMed, Scopus, and Web of Science) for articles published between 2020 and 2022, with 735 peer-reviewed papers identified. After screening for duplicates and relevance, 87 articles were included in this systematic review. The selected articles included various inflammatory, haematological, hepatic, respiratory, cardiac and other clinical biomarkers that were used to predict the severity and mortality risk in COVID-19 patients. In hospitalised COVID-19 patients, the blood levels of specific cytokines and chemokines were significantly higher, including pro-inflammatory cytokines such as interleukin (IL)-6, IL-8, IL-18, and tumour necrosis factor, as well as chemokines like interferon gamma-induced protein 10, monocyte chemoattractant protein-1, and macrophage inflammatory protein-1 alpha. The levels of the anti-inflammatory cytokine IL-10 were also found to be higher, while elevated levels of C-reactive protein, procalcitonin, and ferritin in COVID-19 patients were related to the increased severity and mortality risk of the disease. Growth/differentiation factor 15 and beta-2 microglobulin were also useful biomarkers and independent risk factors for death in COVID-19 patients. The review revealed clinical biomarkers that can be used as indicators of COVID-19 disease progression and are critical to timely interventions. Understanding the clinical picture associated with biomarker profiles is necessary for future improved COVID-19 management strategies and therapeutic approaches.