Plasma CRP level is positively associated with the severity of COVID-19

Wei Chen,Kenneth I Zheng,Chongyong Xu,Zengpei Qiao,Saiduo Liu,Zhihan Yan

doi:10.1186/s12941-020-00362-2

Abstract

AimsThe coronavirus disease 2019 (COVID-19) is characterized as highly contagious and deadly; however there is no credible and convenient biomarker to predict the severity of the disease. The aim of the present study was to estimate whether the CRP level is able to act as a marker in indicating the severity of COVID-19.MethodsPatients who complained cough or chest pain with or without fever were enrolled after laboratory confirmed of SARS-CoV-2 viral nucleic acid via qRT-PCR. Chest computed tomography (CT) was then performed to classify the patients into mild, moderate and severe pneumonia groups according to the interim management guideline. Then linear regression models were applied to analyze the association between c-reactive protein (CRP) levels and severity of COVID-19 pneumonia.ResultsWhen compared to mild pneumonia, the adjusted-Odds Ratio were 11.46, p = 0.029 and 23.40, p = 0.025 in moderate and severe pneumonia, respectively. The area under receiver operation curve was 0.898 (95% CI 0.835, 0.962, p < 0.001). Higher plasma CRP level indicated severe COVID-19 pneumonia and longer inpatients duration.ConclusionsThe level of plasma CRP was positively correlated to the severity of COVID-19 pneumonia. Our findings could assist to discern patients of moderate to severe COVID-19 pneumonia from the mild ones. Our findings may be useful as an earlier indicator for severe illness and help physicians to stratify patients for intense care unit transfer.

Highlights

Coronavirus belongs to the subfamily of Ortho-coronavirinae in the family of Coronaviridae and the Order Nidovirales
One reliable and convenient biomarker is needed to predict the severity of COVID-19 pneumonia
Several studies have reported that C-reactive protein (CRP) is positively associated with severe dengue infection, and patients with higher plasma CRP in the initial period of dengue, are at higher risk to develop plasma leakage [2, 3]

Summary

Introduction

Coronavirus belongs to the subfamily of Ortho-coronavirinae in the family of Coronaviridae and the Order Nidovirales. In 2003, a SARS-CoV had caused the outbreak of severe acute respiratory syndrome [1]. By the end of February 2020, more than 78,631 cases infected with SARS-CoV-2, and more than 2747 deaths were confirmed. For those infected by SARS-CoV-2, some of the patients did not show hypoxemia or respiratory stress during the course of COVID-19, indicating a multifaceted disease of SARS-CoV-2 infection. Several studies have reported that C-reactive protein (CRP) is positively associated with severe dengue infection, and patients with higher plasma CRP in the initial period of dengue, are at higher risk to develop plasma leakage [2, 3]

Methods

Results

Conclusion