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Diagnostic and prognostic value of inflammatory markers for patients with severe pneumonia: a meta-analysis

Meng Han, Can Zhang, Songhe Zhao, Hong-Yan Zhang

Biomarkers in Medicine, 2025

463 participants

Abstract

AIMS

This meta-analysis evaluates the diagnostic and prognostic performance of severe pneumonia through a comprehensive meta-analysis.

PATIENTS AND METHODS

A systematic literature search was conducted across PubMed, Embase, Cochrane Library, Web of Science, and Scopus. Studies were included if they focused on severe pneumonia patients, assessed relevant inflammatory markers, and provided sufficient data for meta-analysis.

RESULTS

The diagnostic meta-analysis found a sensitivity of 0.72 (95% CI: 0.64-0.79) and a specificity of 0.75 (95% CI: 0.70-0.80). Area under the summary receiver operating characteristic curve was 0.80 (95% CI: 0.76-0.83). However, these pooled estimates showed high heterogeneity (I2 > 80%), indicating substantial variation across studies and requiring cautious interpretation. Subgroup analyses revealed that procalcitonin (PCT) had the highest specificity. For predicting short-term mortality, a preliminary analysis of five studies (n = 463) showed a pooled sensitivity of 0.72 (95% CI: 0.64-0.79) and a specificity of 0.65 (95% CI: 0.59-0.70), suggesting a potential prognostic signal that needs validation in larger, prospective cohorts.

CONCLUSIONS

Inflammatory markers are valuable auxiliary tools to support clinical judgment in assessing severity and predicting outcomes in patients with severe pneumonia. They offer moderate accuracy in distinguishing severe from non-severe cases and in predicting short-term mortality.

How strong is the evidence?

Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 463 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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