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Prognostic Value of C-Reactive Protein in Patients With Coronavirus 2019
Xiaomin Luo1, Wei Zhou2, Xiaojie Yan1
1Department of Emergency, Eastern Campus, Renmin Hospital of Wuhan University, Wuhan, China.
Insights
Elevated C-reactive protein (CRP) levels in COVID-19 patients indicate disease severity. Admission CRP is a strong predictor of adverse outcomes, outperforming age and neutrophil counts in prognosis.
Area of Science:
- Infectious Diseases
- Immunology
- Clinical Medicine
Background:
- Coronavirus disease 2019 (COVID-19) is associated with elevated serum C-reactive protein (CRP) levels.
- Understanding prognostic markers is crucial for managing COVID-19 patients.
Purpose of the Study:
- To evaluate the prognostic value of admission C-reactive protein (CRP) levels in patients diagnosed with COVID-19.
- To assess the correlation between CRP levels and disease severity and adverse outcomes in COVID-19.
Main Methods:
- Retrospective analysis of clinical data from 298 COVID-19 patients in Wuhan, China (January 30 - February 20, 2020).
- Evaluation of admission CRP levels and other laboratory markers as predictors of clinical outcomes.
- Receiver operating characteristic (ROC) curve analysis to determine the predictive accuracy of CRP.
Main Results:
- Nonsurvivors (84/298) were more likely male, older, or had chronic diseases compared to survivors (214/298).
- Nonsurvivors exhibited significantly higher white blood cell count, neutrophil count, neutrophil-to-lymphocyte ratio (NLR), CRP, and D-dimer levels.
- Admission CRP demonstrated a high area under the ROC curve (0.896) for predicting adverse outcomes, surpassing age and neutrophil counts. A cutoff of 41.4 yielded 90.5% sensitivity and 77.6% specificity.
Conclusions:
- Admission C-reactive protein (CRP) levels are correlated with COVID-19 disease severity.
- CRP serves as a valuable independent predictor of adverse outcomes in COVID-19 patients.
- The prognostic utility of CRP in COVID-19 warrants further clinical consideration.
Background:
An elevated serum C-reactive protein (CRP) level was observed in most patients with coronavirus disease 2019 (COVID-19).
Methods:
Data for COVID-19 patients with clinical outcome in a designated hospital in Wuhan, China, were retrospectively collected and analyzed from 30 January 2020 to 20 February 2020. The prognostic value of admission CRP was evaluated in patients with COVID-19.
Results:
Of 298 patients enrolled, 84 died and 214 recovered. Most nonsurvivors were male, older, or with chronic diseases. Compared with survivors, nonsurvivors showed significantly elevated white blood cell and neutrophil counts, neutrophil to lymphocyte ratio (NLR), systemic immune inflammation index (defined by platelet count multiplied by NLR), CRP, procalcitonin, and D-dimer and showed decreased red blood cell, lymphocyte, and platelet counts. Age, neutrophil count, platelet count, and CRP were identified as independent predictors of adverse outcome. The area under the receiver operating characteristic (ROC) curve (AUC) of CRP (0.896) was significantly higher than that of age (0.833), neutrophil count (0.820), and platelet count (0.678) in outcome prediction (all P < .05). With a cutoff value of 41.4, CRP exhibited sensitivity of 90.5%, specificity of 77.6%, positive predictive value of 61.3%, and negative predictive value of 95.4%. CRP was also an independent discriminator of severe/critical illness on admission with an AUC (0.783) comparable to age (0.828) and neutrophil count (0.729) (both P > .05).
Conclusions:
In patients with COVID-19, admission CRP correlated with disease severity and tended to be a good predictor of adverse outcome.
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