Systematic Reviews
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Methodol. Sep 20, 2022; 12(5): 438-447
Published online Sep 20, 2022. doi: 10.5662/wjm.v12.i5.438
Growth differentiation factor 15 as an emerging novel biomarker in SARS-CoV-2 infection
Deepak Parchwani, Sagar Dholariya, CDS Katoch, Ragini Singh
Deepak Parchwani, Sagar Dholariya, Ragini Singh, Department of Biochemistry, All India Institute of Medical Sciences, Rajkot 360001, Gujarat, India
CDS Katoch, Department of Pulmonary Medicine, All India Institute of Medical Sciences, Rajkot 360001, Gujarat, India
Author contributions: Parchwani D and Dholariya S contributed equally to this work from the design of study, search and scrutiny of articles, analysis and manuscript writing to proof reading; Katoch CDS designed the research study, scrutiny of articles and manuscript writing; Singh R literature search and analysis; all authors have read and approve the final manuscript.
Conflict-of-interest statement: Authors hereby declare that there in no conflict of intrest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2020 Checklist, and the manuscript was prepared and revised according to the PRISMA 2020 guidelines.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sagar Dholariya, MD, Assistant Professor, Department of Biochemistry, All India Institute of Medical Sciences, Jamnagar Road, Khandheri, Rajkot 360001, Gujarat, India. drsagar.dholariya@gmail.com
Received: March 5, 2022
Peer-review started: March 5, 2022
First decision: June 16, 2022
Revised: June 29, 2022
Accepted: August 30, 2022
Article in press: August 30, 2022
Published online: September 20, 2022
Processing time: 195 Days and 4.9 Hours
Abstract
BACKGROUND

Growth differentiation factor (GDF)-15 is a member of a transforming growth factor-β cytokine superfamily that regulates metabolism and is released in response to inflammation, hypoxia and tissue injury. It has evolved as one of the most potent cytokines for predicting the severity of infections and inflammatory conditions, such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.

AIM

To investigate the utility of GDF-15 in predicting the severity of SARS-CoV-2 infection.

METHODS

PubMed, Reference Citation Analysis, CNKI, and Goggle Scholar were explored by using related MeSH keywords and data such as the first author’s name, study duration, type and place of study, sample size and subgroups of participants if any, serum/plasma GDF- 15 level in pg/mL, area under the curve and cut-off value in receiver operating characteristic analysis, method of measurement of GDF-15, and the main conclusion were extracted.

RESULTS

In all studies, the baseline GDF-15 level was elevated in SARS-CoV-2-infected patients, and it was significantly associated with severity, hypoxemia, viral load, and worse clinical consequences. In addition, GDF-15 levels were correlated with C-reactive protein, D-dimer, ferritin and procalcitonin, and it had superior discriminatory ability to detect severity and in-hospital mortality of SARS-CoV-2 infection. Hence, GDF-15 might be used to predict the severity and prognosis of hospitalized patients with SARS-CoV-2.

CONCLUSION

Serial estimation of GDF-15 levels in hospitalized patients with SARS-CoV-2 infection appeared to have useful prognostic value and GDF-15 can be considered a clinically prominent sepsis biomarker for SARS-CoV-2 infection.

Keywords: SARS-CoV-2; Growth differentiation factor 15; Biomarker; Risk-stratification; Prognosis

Core Tip: Growth differentiation factor (GDF)-15 levels are higher in hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and higher levels are associated with disease severity, viremia and hypoxemia. The consistent increase in the concentration of GDF-15 during a hospital stay is associated with worse outcomes. Hence, serial monitoring of GDF-15 concentrations may provide useful prognostic value for hospitalized patients with SARS-CoV-2. GDF-15 appears to be involved in the underlying pathophysiology, laying the foundation for a novel therapeutic approach for SARS-CoV-2.