Relationship between acute phase reactants and prognosis in patients with or without COVID-19 pneumonia

Abstract

In December 2019, several cases of pneumonia of unknown origin were reported in the city of Wuhan, province of Hubei, China. The pathogen was named as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the disease was named coronavirus disease 2019 (COVID-19). Acute phase reactans (APRs) are critical in the early diagnosis, treatment, and for monitoring the progression of COVID-19. Seventy two patients were included in the study and infections confirmed by real-time reverse transcription polymerase chain reaction. Clinical parameters, the level of APFs and D-dimer were assessed and results were retrived from the patients’ medical records. Chest computed tomography (CT) findings were described for each patient and they were divided into two groups, with or without COVID-19 pneumonia. The correlation between APRs and CT findings and the patients’ prognosis were evaluated. Twenty eight (38.8%) of the 72 patients were female and 44 (61.2%) were male. The most common symptom was cough (43%) and the most common associated chronic disease was hypertension (12.5%). Thirty (41.6%) patients had completely normal chest CT, while 42 (58.4%) patients had typical findings in terms of COVID-19 pneumonia. C reactive protein (CRP), lactate dehydrogenase (LDH), erythrocyte sedimentation rate (ESR), ferritin, procalcitonin and D-Dimer levels were statistically significantly higher in patients with pneumonia than in those without pneumonia and these parameters were also statistically significantly higher in patients with severe illness. In conclusion, CRP, LDH, ESR, ferritin, and D-Dimer were associated with severe COVID-19 pneumonia. These biomarkers can be used to evaluate the prognosis to predict the clinical course of disease, allowing a proper management and treatment of the patients.

The utility of serum amyloid A and other acute-phase reactants determination in ambulatory care COVID-19 patients

“…Also, hospitalized patients had higher median values of D-dimer, which is consistent with disease severity in this group of patients. We observed that D-dimer levels were progressively higher with an increase in disease severity, similar to previous studies (11,12,29). Sayit et al (12) reported that D-dimer is a good marker of pneumonia severity, and their study showed that D-dimer is elevated without obvious thromboembolism.…”

“…We observed that D-dimer levels were progressively higher with an increase in disease severity, similar to previous studies (11,12,29). Sayit et al (12) reported that D-dimer is a good marker of pneumonia severity, and their study showed that D-dimer is elevated without obvious thromboembolism. Besides a good correlation with disease severity and hospitalization, based on ROC curve analysis in our study, D-dimer failed to show any valuable addition for assessing COVID-19 patients in ambulatory care settings and, as such, should be used with caution.…”

“…During the acute-phase reaction, the serum concentrations of SAA1 and SAA2 rise quickly due to accelerated transcription of their respective genes (10) as a response to proinflammatory cytokines such as tumor necrosis factor-a (TNF-a), interleukins (e.g., 1a, 1b, and 6), transforming growth factor-b (TGF-b), and interferong (INF-g) (9). So far, many studies have evaluated APRs to assess disease severity and prognosis of SARS-CoV-2 infection (7,(11)(12)(13)(14)(15)(16)(17)(18)(19), mostly in hospitalized patients, where SAA showed a positive correlation with disease severity and prognosis. It also demonstrated better characteristics for the same purpose when compared to other APRs (13,(20)(21)(22).…”