Prediction of coronavirus disease severity based on increased levels of microvesicles: A systematic review and meta-analysis
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Abstract
Background: Elevated microvesicle (MV) levels are potential biomarkers of coronavirus disease 2019 (COVID-19). We compared different types of microvesicles (total microvesicles, TMVs), platelet-derived microvesicles (PMVs), endothelium-derived microvesicles (EMVs), and tissue factor-bearing microvesicles (TF-MVs).
Objectives: We investigated the correlations between microvesicles and D-dimers, as well as between microvesicles and COVID-19 severity.
Materials and methods: A systematic literature search was conducted in PubMed, Web of Science, Scopus, and ScienceDirect to identify relevant studies comparing microvesicle types between patients with COVID-19 and healthy controls. Pooled estimates of the standardized mean difference (SMD) for each MV type were calculated using RevMan 5.4, along with the corresponding 95% confidence intervals (CIs).
Results: This meta-analysis included six studies comprising 183 COVID-19 patients and 135 healthy controls for quantitative analysis. Compared with controls, COVID-19 patients presented significantly higher levels of circulating TMVs, PMVs, EMVs, and TF-MVs (TMVs: SMD=4.27, 95% CI 2.18-6.36, p<0.0001; PMVs: SMD=2.07, 95% CI 0.99-3.15, p=0.0002; EMVs: SMD=1.20, 95% CI 0.56-1.84, p=0.0002; and TF-MVs: SMD=2.56, 95% CI 1.98-3.15, p<0.00001). D-dimer levels were correlated with MV levels (N=82, r=0.430, 95% CI 0.227-0.592, p<0.0001). In general, MVs were correlated with COVID-19 severity (N=168; r=0.942; 95% CI, 0.558-0.993; p=0.002).
Conclusion: Patients with severe COVID-19 had elevated levels of TMVs, PMVs, EMVs, and TF-MVs. Therefore, MVs may contribute to the procoagulant effects associated with prognostic and severity biomarkers of COVID-19.
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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Personal views expressed by the contributors in their articles are not necessarily those of the Journal of Associated Medical Sciences, Faculty of Associated Medical Sciences, Chiang Mai University.
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