Barw Barw Medical Journal 2960-1959 2024 06 30 Role of Inflammatory Markers in Severity, ICU Admission, and Mortality in COVID-19: A Systematic Review and Meta-analysis of 79,934 Patients 10.58742/bmj.v2i2.96 eng Hiwa O. Abdullah Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Kurdistan, Iraq. hiewaom96@gmail.com Sadraldin A. Braim Smart Health Tower (Raparin Branch), Karukh Street, Ranya, Sulaymaniyah, Kurdistan, Iraq. sadraldin.braim@gmail.com Maria A. Rasool Smart Health Tower (Raparin Branch), Karukh Street, Ranya, Sulaymaniyah, Kurdistan, Iraq. maria.rasool@gmail.com Dashne M. Abdalla Smart Health Tower (Raparin Branch), Karukh Street, Ranya, Sulaymaniyah, Kurdistan, Iraq. Dashne.Abdalla@gmail.com Dyari Q. Hamad Smart Health Tower (Raparin Branch), Karukh Street, Ranya, Sulaymaniyah, Kurdistan, Iraq. dyair.hamad@gmail.com Daban K. Ahmad Smart Health Tower (Raparin Branch), Karukh Street, Ranya, Sulaymaniyah, Kurdistan, Iraq. Daban.Ahmad@gmail.com Ayman M. Mustafa Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Kurdistan, Iraq. AymanM.Mustafa@gmail.com Fakher Abdullah Kscien Organization for Scientific Research (Europe office), Rotterdam, Netherlands. fakher.abdullah@gmail.com Yousif M. Mahmood Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Kurdistan, Iraq. yousif.mahmood@gmail.com Dilan S. Hiwa Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Kurdistan, Iraq. dilan.hiwa@gmail.com Sasan M. Ahmed Kscien Organization for Scientific Research (Middle East Office), Hamid Street, Azadi Mall, Sulaymaniyah, Kurdistan, Iraq. Sasan.Ahmed@gmail.com Karokh K. Mohammed Smart Health Tower (Raparin Branch), Karukh Street, Ranya, Sulaymaniyah, Kurdistan, Iraq. karokh12@gmail.com Berun A. Abdalla Department of Biology, College of Education, University of Sulaimani, Madam Mitterrand Street, Sulaymaniyah, Kurdistan, Iraq. berun.anwer95@gmail.com Shvan H. Mohammed Xzmat Polyclinic, Rizgari, Kalar, Sulaymaniyah, Kurdistan, Iraq. shvan.mohammed@gmail.com Fahmi H. kakamad College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaymaniyah, Kurdistan, Iraq. fahmi.hussein@univsul.edu.iq 2024 04 29 Introduction Despite extensive investigations into the roles of inflammatory biomarkers in the prognosis of COVID-19 through systematic reviews and meta-analyses, they are limited by small sample sizes and focus on a specific marker. This meta-analysis investigated the role of 11 inflammatory biomarkers in severity, intensive care unit (ICU) admission, and mortality among COVID-19 patients. Methods Studies up to October 25, 2023, were identified through a search of Google Scholar, limited to human studies published in English. Inclusion criteria required confirmed COVID-19 cases diagnosed via reliable laboratory methods, original articles from eligible journals, proper grouping of severity status, ICU admission, or mortality outcomes, and presentation of continuous data in mean and standard deviation, median with range, or interquartile range. Results A total of 241 studies, comprising 79,934 cases of COVID-19, were included in this study. Albumin levels significantly declined in severe, ICU, and dead cases compared to mild, moderate, non-ICU, and survived cases (p<0.001). C-reactive protein (CRP), D-dimer, erythrocyte sedimentation rate (ESR), ferritin, fibrinogen, Interleukin-6 (IL-6), lactate dehydrogenase (LDH), neutrophil-to-lymphocyte ratio (NLR), procalcitonin, and white blood cell (WBC) were all significantly (p<0.001) increased and correlated with the severity of COVID-19. CRP, D-dimer, ferritin, fibrinogen, IL-6, LDH, NLR, procalcitonin, and WBC were all significantly (p<0.05) elevated and correlated with the risk of ICU admission (except fibrinogen) and mortality in COVID-19 in both fixed and random effects. Conclusion Inflammatory biomarkers like albumin, CRP, D-dimer, ferritin, IL-6, LDH, NLR, procalcitonin, and WBC all significantly impact severity status, ICU admission, and mortality in COVID-19.