Related Experiment Video
Updated: Nov 21, 2025
Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
C-reactive protein and clinical outcomes in patients with COVID-19
Nathaniel R Smilowitz1,2, Dennis Kunichoff3, Michael Garshick1
1Leon H. Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, NY, USA.
Insights
High C-reactive protein (CRP) levels in COVID-19 patients indicate severe systemic inflammation. Elevated CRP is linked to increased risk of venous thromboembolism, acute kidney injury, critical illness, and mortality.
Area of Science:
- Infectious Diseases
- Immunology
- Critical Care Medicine
Background:
- Coronavirus disease 2019 (COVID-19) is characterized by a systemic inflammatory response.
- Elevated C-reactive protein (CRP) levels are markers of inflammation and are associated with severe outcomes in various infections.
Purpose of the Study:
- To investigate the association between initial C-reactive protein (CRP) concentration and clinical outcomes in hospitalized COVID-19 patients.
- To determine if CRP levels can predict adverse events such as venous thromboembolism, acute kidney injury, critical illness, and mortality.
Main Methods:
- A cohort study included 2782 adult patients hospitalized with COVID-19 between March and April 2020.
- C-reactive protein (CRP) levels were measured at initial presentation for 2601 patients.
- Clinical outcomes including venous thromboembolism (VTE), acute kidney injury (AKI), critical illness, and in-hospital mortality were recorded.
Main Results:
- Patients with CRP levels above the median (108 mg/L) showed significantly higher rates of VTE, AKI, critical illness, and mortality compared to those with lower CRP levels.
- Adjusted odds ratios indicated a 2.33-fold increased risk for VTE, 2.11-fold for AKI, 2.83-fold for critical illness, and 2.59-fold for mortality in patients with high CRP.
- A dose-response relationship was observed between CRP concentration and adverse outcomes, with the highest risk in patients with both high CRP and high D-dimer levels.
Conclusions:
- Systemic inflammation, indicated by elevated CRP levels, is strongly associated with adverse clinical outcomes in COVID-19 patients.
- CRP serves as a valuable marker for risk stratification in COVID-19.
- Further research should explore CRP-guided treatment strategies and risk stratification approaches for COVID-19 management.
Background:
A systemic inflammatory response is observed in coronavirus disease 2019 (COVID-19). Elevated serum levels of C-reactive protein (CRP), a marker of systemic inflammation, are associated with severe disease in bacterial or viral infections. We aimed to explore associations between CRP concentration at initial hospital presentation and clinical outcomes in patients with COVID-19.
Methods And Results:
Consecutive adults aged ≥18 years with COVID-19 admitted to a large New York healthcare system between 1 March and 8 April 2020 were identified. Patients with measurement of CRP were included. Venous thrombo-embolism (VTE), acute kidney injury (AKI), critical illness, and in-hospital mortality were determined for all patients. Among 2782 patients hospitalized with COVID-19, 2601 (93.5%) had a CRP measurement [median 108 mg/L, interquartile range (IQR) 53-169]. CRP concentrations above the median value were associated with VTE [8.3% vs. 3.4%; adjusted odds ratio (aOR) 2.33, 95% confidence interval (CI) 1.61-3.36], AKI (43.0% vs. 28.4%; aOR 2.11, 95% CI 1.76-2.52), critical illness (47.6% vs. 25.9%; aOR 2.83, 95% CI 2.37-3.37), and mortality (32.2% vs. 17.8%; aOR 2.59, 95% CI 2.11-3.18), compared with CRP below the median. A dose response was observed between CRP concentration and adverse outcomes. While the associations between CRP and adverse outcomes were consistent among patients with low and high D-dimer levels, patients with high D-dimer and high CRP have the greatest risk of adverse outcomes.
Conclusions:
Systemic inflammation, as measured by CRP, is strongly associated with VTE, AKI, critical illness, and mortality in COVID-19. CRP-based approaches to risk stratification and treatment should be tested.
More Related Videos
08:51Author Spotlight: Integrated Multi-Omics Analysis for Unveiling Multicellular Immune Signatures in Clinical Heart Attack Cohorts
Published on: September 20, 2024
07:40Impact of High-intensity Interval Exercise and Moderate-Intensity Continuous Exercise on the Cardiac Troponin T Level at an Early Stage of Training
Published on: October 10, 2019
Related Concept Videos
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
01:19Pericarditis II: Clinical Features and Diagnostic Tests
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
01:27Myocarditis II: Clinical Features and Diagnostic Tests
01:30Acute Coronary Syndrome III: Diagnostic Studies