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

Background: The COVID-19 pandemic has imposed a significant global health burden. Identifying prognostic markers for COVID-19 and its severity could contribute to improved patient outcomes by reducing morbidity and mortality. This systematic review and meta-analysis aimed to evaluate the relationship between ischemic-modified albumin (IMA) and thiol levels, both indicators of oxidative stress, in patients diagnosed with COVID-19.

Method: We conducted a comprehensive search across PubMed, Scopus, Embase, and Web of Science for eligible original studies. The study assessed IMA and thiol levels in COVID-19 patients, examining their association with both disease severity and mortality. A random effect analysis was conducted to estimate the standardized mean difference (SMD) and confidence intervals (CI).

Results: Sixteen studies comprising 2010 COVID-19 patients and 982 controls were included. A diagnosis of COVID-19 was associated with significantly elevated IMA levels (Hedges's g = 1.02, 95% CI: 0.45 to 1.60) and reduced total thiol levels (Hedges's g = -1.08, 95% CI: -2.10 to -0.07). However, native thiol levels did not reveal a significant difference between infected patients and healthy participants. Subgroup analysis showed significantly lower total thiol levels in patients with critical and severe COVID-19, as well as lower native thiol levels specifically in critical COVID-19 patients. IMA levels were significantly higher across the critical, severe, and moderate COVID-19 groups.

Conclusion: Elevated IMA and reduced thiol levels may serve as novel markers for predicting COVID-19 severity and prognosis. Further research is needed to explore therapeutic interventions that target oxidative imbalance in COVID-19 patients.