Prognostic value of apolipoproteins in COVID-19 patients: A systematic review and meta-analysis

Juan R. Ulloque-Badaracco, Enrique A. Hernandez-Bustamante, Percy Herrera-Añazco, Vicente A. Benites-Zapata

Research output: Contribution to journalReview articlepeer-review

7 Scopus citations


INTRODUCTION: Apolipoproteins are predictive biomarkers for cardiovascular, neoplasms and cerebrovascular diseases and are postulated as prognostic biomarkers in infectious diseases, as COVID-19. Thus, we assessed the prognosis value of apolipoproteins for COVID-19 severity and mortality.

METHODS: We conducted a systematic review and meta-analysis using observational studies that reported the association between apolipoproteins and severity or mortality in COVID-19 patients. Newcastle-Ottawa was used for the quality assessment of included studies. Effects measurements were shown as odds ratios (ORs) with 95% confidence intervals (CIs), and Egger-test was developed for assessing the risk of bias publication.

RESULTS: We analyzed 12 cohort studies (n = 3580). Patients with low ApoliproteinA1 (ApoA1) (OR 0.35; 95%CI 0.24 to 0.49; P < 0.001) and ApoliproteinB (ApoB) (OR = 0.78; 95%CI 0.69 to 0.87; P < 0.001) values had a higher risk of developing severe disease. ApoB/ApoA1 ratio showed no statistically significant association with higher odds of severity. Low ApoA1 levels were associated with higher odds of all-cause mortality (OR = 0.34; 95%CI 0.20 to 0.57; P < 0.001). ApoB values showed no statistically significant association with a high risk of all-cause mortality.

CONCLUSION: We suggest that adequate levels of ApoA1 and ApoB can be a protective factor for severity in COVID-19, and ApoB/ApoA1 ratio did not show predictive utility for severity.

Original languageEnglish
Article number102200
Pages (from-to)102200
JournalTravel Medicine and Infectious Disease
StatePublished - 1 Nov 2021
Externally publishedYes


  • ApoA
  • ApoB
  • Mortality
  • Prognosis
  • Sars-Cov-2


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