C-reactive Protein In Control Group Research Articles

Plasma D-Dimer Value Corrected with Some Physiological and Inflammatory Markers (C-Reactive Protein and Ferritin) in Iraqi Patients with COVID-19 Infection

Since the beginning of the COVID-19 pandemic it has been observed that patients have elevated plasma levels of D-dimer and some inflammatory markers (ferritin, interleukine 6, C-reactive protein (CRP) or fibrinogen). Some studies point to the existence of a certain correlation between those markers and D-dimer. CRP is a protein discovered in the 1930s by Tillett and Francis and is an acute phase reactant. It is a pentameric protein which is synthesized by the liver under the action of cytokine interleukin 6 (IL-6). D-dimers are multiple peptide fragments produced as a result of degradation of crosslinked fibrin, mediated by plasmin. A total of 60 patients were recruited and categorized into :1- group1 (controls), 2- group 2 (COVID-19 patients). 5 ml of blood was obtained from each patient by vein puncture, using 5 ml disposable syringes, then centrifuged at 3000 rpm for 10 minutes to collect the serum. D- dimer, C-reactive protein were measured by using (Roche Diagnostics GmbH, Mannheim, Germany). At the same time, the Ferritin was assessed by using a miniVIDAS analyzer for the fluorescent enzymatic detection of β2-microglobulin (β2M) using the technique. Enzyme Linked Fluorescent Assay (ELFA) (BioMerieux). Our results showed that there was a non- significant difference in the P-values between control and patients males and females. The Mean ± SE of age in control group was 45.90 ± 3.34, while the Mean ± SE of age in patients was 45.35 ± 2.52. There was a non- significant difference between the two groups, the Mean ± SE of CRP in control group was 5.04 ±0.81, while the Mean ± SE of CRP in COVID-19 patients was 37.16 ±3.24, there was a highly Significant differences between them (P≤0.01). The CRP of COVID-19 patients were compared with those of control patients, the results shows significant increased CRP in covid-19 patients group as a compression with the control group, the findings of the study is similar to Jacob Lentner, etal findings. In response to infections, the liver synthesizes significant quantities of acute-phase proteins (APPs), such as CRP. This acute inflammatory protein is a highly sensitive biomarker for inflammation, tissue damage, and infection. It has been shown that CRP levels are correlated with levels of inflammation. CRP levels can promote phagocytosis and activate the complement system. In other words, CRP binds to microorganisms and promotes their removal through phagocytosis. D-dimers are one of the fragments produced when plasmin cleaves fibrin to break down clots. Our study showed that the serum D-dimer concentrations in patients significantly higher than those in control group which is similar to Mamta Soni, etal, 2020 findings. Elevated D-dimer levels have emerged as a consistent finding in severely ill COVID-19 patients, Multiple studies have identified an association between higher D-dimer levels and an increased risk of mortality in the COVID-19 patient population. Ferritin is an iron-storing protein; its serum level reflects the normal iron level and helps the diagnosis of iron deficiency anemia. Circulation ferritin level increases during viral infections and can be a marker of viral replication. Our study showed a significant increase in ferritin level in covid-19 patients group compared to control group, which consider similar to [] results. Although the exact cause for elevated ferritin in COVID-19 infection is unknown, it could be influenced by cytokine release or cellular damage that results in the leakage of intracellular ferritin. It has been previously shown that ferritin is a direct indicator of cellular damage suggestive of an association between organ damage and ferritin production. This could later cause cell death, known as ferroptosis. It is suggested that inflammation associated with sepsis could alter iron metabolism and deficiency to facilitate the immune system, which could be an early sign of COVID.

Clinical study of awake prone positioning treatment in patients with common coronavirus disease 2019 caused by Omicron variant

To evaluate the clinical effect of awake prone positioning (APP) for common coronavirus disease 2019 (COVID-19) caused by Omicron variant. Retrospectively analyze the clinical data of patients with COVID-19 caused by Omicron variant admitted by medical team of Tianjin Third Central Hospital during the period of supporting Tianjin COVID-19 designated hospital from January 8 to February 20, 2022. Patients who met the diagnostic criteria for common COVID-19 and had risk factors for developing severe disease or had pulse oxygen saturation (SpO2) ≤ 0.93 after exercise without supplementary oxygen were enrolled. Patients were divided into APP group and control group according to whether they completed the daily 12-hours APP in the first three days after enrollment. Demographic characteristics, clinical symptoms, COVID-19 vaccination status, laboratory examination, disease progression (progression to severe), time to nucleic acid negative conversion, length of hospital stay, and adverse reactions and tolerability [visual analog scale (VAS) score (the higher the score, the worse the tolerability] during APP were evaluated in two groups. Interleukin-6 (IL-6), C-reactive protein (CRP), SpO2/inhaled oxygen concentration (FiO2) ratio and ROX index (ROXI) were compared between two groups at enrollment, 3rd and 7th day after enrollment. There were no significant differences in demographic characteristics, clinical symptoms, vaccination rates of COVID-19 and laboratory tests between the two groups. There were no statistically significant differences in IL-6, CRP, SpO2/FiO2 ratio and ROXI between two groups at the time of enrollment. Compared with the group at the time of enrollment, SpO2/FiO2 ratio and ROXI in APP group increased significantly at the 3rd day after enrollment [SpO2/FiO2 ratio: 461.90 (457.10, 466.70) vs. 446.67 (437.14, 457.10), ROXI: 25.40 (23.33, 25.93) vs. 22.57 (21.86, 24.40), all P < 0.05], and the levels of IL-6 and CRP in control group were significantly increased [IL-6 (ng/L): 18.30 (6.50, 37.75) vs. 7.40 (5.10, 11.15), CRP (mg/L): 11.46 (2.11, 17.96) vs. 4.11 (1.72, 9.05), all P < 0.05]. At the 3rd day of enrollment, the levels of IL-6 and CRP in APP group were significantly lower than those in control group [IL-6 (ng/L): 7.35 (4.35, 12.80) vs. 18.30 (6.50, 37.75), CRP (mg/L): 4.52 (1.98, 9.66) vs. 11.46 (2.11, 17.96), all P < 0.05], while SpO2/FiO2 ratio and ROXI were significantly higher than those in control group [SpO2/FiO2 ratio: 461.90 (457.10, 466.70) vs. 446.67 (441.90, 459.52), ROXI: 25.40 (23.33, 25.93) vs. 23.31 (22.10, 24.66), all P < 0.05]. At the 7th day of enrollment,there were no significant differences in IL-6, CRP, SpO2/FiO2 ratio and ROXI between two groups. There were no severe cases in both groups. The time of nucleic acid negative conversion and length of hospital stay in APP group were significantly shorter than those in control group [10.0 (8.0, 12.0) days vs. 11.0 (9.0, 13.0) days, 12.0 (10.0, 14.0) days vs. 14.0 (12.0,16.0) days, respectively, all P < 0.05]. The main adverse reaction during APP was back pain, and the incidence in APP group was slightly lower than that in control group, but the difference was not statistically significant [17.9% (17/95) vs. 26.5% (27/102), P = 0.149]. VAS score in control group was significantly higher than that in APP group [score: 2.5 (2.0, 4.0) vs. 2.0 (1.0, 3.0), P = 0.004]. In common COVID-19 patients caused by Omicron variant with high risk factors for progression to severe disease or decreased oxygen reserve capacity, early APP can shorten the time of nucleic acid negative conversion and the length of hospital stay, but its effect on preventing disease progression cannot be determined.

C - reactive protein As An Immunopathological Prognostic Marker For Giardia Lamblia And Entamoeba Histolytica Associated Diarrhea Among Children Of Baghdad Governorate

Background: C-reactive protein (CRP) is one of the classic acute phase proteins. The study of induction of acute phase reactants synthesis in parasitic infections would aid in understanding the host parasite relationship.Methods: Seventy three children with parasitic diarrhea that proved through clinical and microbiological investigation were selected. Thirteen of selected children were infected with G.lamblia and the rest sixty were infected with E.histolytica . Nineteen of the control group was females while the rest eleven were males. Venous Blood were collected from patients and control group for detection of CRP level via latex agglutination test. Results : The high rate of infection was detected among the age group (19-36) months. The highest level of CRP was (192 mg/dl) while the lowest one was (12 mg/dl) with a mean level (51.20 mg/dl). the mean level of CRP in control group was (3.7500 mg/dl). positive significant correlations between CRP level and the age of infected children (r=0.290,p=0.013), the chronic infection with G.lamblia and E.histolytica (r=0.760,p=0.000) . Positive significant correlation between the age group and the chronic infection with G.lamblia and E.histolytica (r=0.493,p=0.000) . Significant difference was detected between the patients group and control group regarding the CRP level (p&gt;0.05).Conclusion: This study proved that CRP level was increased in association with the age and chronic presentation of diarrhea caused by G.lamblia and E.histolytica and can be used as a non specific immunological marker for monitoring of clinical presentation of G.lamblia and E.histolytica associated diarrheal .

Correlation between the inflammatory factors and adipocytokines with gestational diabetes mellitus and their change in puerperium

To investigate the relationship between inflammatory factors, including C-reactive protein(CRP), tumor necrosis factor alpha (TNF-α), adiponectin, leptin and gestational diabetes mellitus (GDM) and their changes in puerperium. From June 2008 to May 2010, 40 cases with gestational diabetes mellitus, 40 cases of normal pregnancy were enrolled in this study. Fasting venous blood were obtained at early pregnancy (10 - 12 weeks), late pregnancy (36 - 38 weeks) and day 3 and 42 of postpartum. Serumal adiponectin, leptin and TNF-α were measured by ELISA, and serumal CRP were measured by particle enhanced immunoturbidimetric method. The levels of those 4 cytokines and homeostasis model assessment insulin resistance (HOMA-IR) index were compared between two groups. And the changes of 4 cytokines were calculated in puerperium. The receiver operating characteristic (ROC) for TNF-α predicting GDM was designed. (1) The relationship between cytokines and HOMA-IR: the levels of adiponectin of (5.7 ± 1.8) mg/L in the GDM group were significantly lower than (8.1 ± 2.7) mg/L in control group in early pregnancy, and the level of adiponectin was negatively correlated with HOMA-IR (r = -0.333, P < 0.05). The levels of (28 ± 10) µg/L of leptin, (10.0 ± 3.4) ng/L of TNF-α and (4.7 ± 1.1) mg/L of CRP in GDM group were significantly higher than (20 ± 8) µg/L of leptin, (4.6 ± 2.7) ng/L of TNF-α, (2.4 ± 1.2) mg/L of CRP in control group, which were positively correlated with HOMA-IR (r = 0.411, 0.529, 0.308, all P < 0.05). In late pregnancy, the level of adiponectin (3.9 ± 2.2) mg/L in the GDM group was significantly lower than (6.6 ± 2.7) mg/L in control group, and the level of adiponectin was negatively correlated with HOMA-IR (r = -0.344, P < 0.05). The levels of (37 ± 13) µg/L of leptin, (12.7 ± 2.6) ng/L of TNF-α and (6.7 ± 3.6) mg/L of CRP in the GDM group were significantly higher than (30 ± 13) µg/L of leptin, (5.8 ± 2.1) ng/L of TNF-α, (4.4 ± 3.1) mg/L of CRP in control group, which were positively correlated with HOMA-IR (r = 0.414, 0.487, 0.285, all P < 0.05). Multiple linear regression analysis showed that the level of TNF-α at early and late pregnancy was most correlated with HOMA-IR (r = 0.390, 0.284, all P < 0.05). (2) The level of the cytokines and HOMA-IR in puerperium: at day 3 of postpartum, the level of adiponectin of (3.3 ± 1.1) mg/L in the GDM group was significantly lower than (6.2 ± 1.5) mg/L in control group, which was negatively correlated with HOMA-IR (r = -0.283, P < 0.05). The levels of (31 ± 13) µg/L of leptin, (10.1 ± 5.7) ng/L of TNF-α and (35.1 ± 6.5) mg/L of CRP in the GDM group were significantly higher than (21 ± 15) µg/L of leptin, (5.6 ± 3.0) ng/L of TNF-α, (30.5 ± 8.5) mg/L of CRP in control group. And leptin and TNF-α levels were positively correlated with HOMA-IR (r = 0.372, 0.494, all P < 0.05). At day 42 of postpartum, the level of adiponectin in GDM group was negatively correlated with HOMA-IR (r = -0.299, P < 0.05), and the levels of leptin and TNF-α were positively correlated with HOMA-IR (r = 0.401, 0.442, all P < 0.05). Multiple linear regression analysis showed that the level of TNF-α at day 3 and day 42 was most correlated with HOMA-IR (r = 0.363, 0.274, all P < 0.05). (3) ROC analysis of data from early pregnancy showed that the threshold for TNF-α to predict GDM was 5.45 ng/L. TNF-α might be the index to predict GDM and evaluate prognosis.