C-reactive protein as an early predictor of COVID-19 severity

Ahnach, Maryame; Zbiri, Saad; Nejjari, S.; Ousti, Fadwa; Elkettani, Chafik

doi:10.5937/jomb0-27554

Cited by 109 publications

(98 citation statements)

References 27 publications

(26 reference statements)

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“…According to the published data [ 4 , 5 , 23 , 26 ], comorbidities, such as hypertension, diabetes mellitus, and obesity, are risk factors for a severe course of COVID-19. We investigated the effect of these comorbidities on the length of hospital stay.…”

Section: Resultsmentioning

confidence: 99%

“…However, despite numerous studies indicating a close relationship between lymphopenia and disease severity, we did not find significant differences in the lymphocyte count in groups of patients with differing severity of COVID-19 in our cohort. Many researchers have suggested considering the C-reactive protein (CRP) as a prognostic factor [ 3 , 36 ], a high level of which is associated with a worsening of the disease. A number of studies [ 3 , 5 , 37 ] have reliably demonstrated a significant increase in the blood CRP level in criticalcondition patients.…”

Section: Resultsmentioning

confidence: 99%

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COVID-19 in Russia: Clinical and Immunological Features of the First-Wave Patients

et al. 2021

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The coronavirus disease outbreak in 2019 (COVID-19) has now achieved the level of a global pandemic and affected more than 100 million people on all five continents and caused over 2 million deaths. Russia is, needless to say, among the countries affected by SARS-CoV-2, and its health authorities have mobilized significant efforts and resources to fight the disease. The paper presents the result of a functional analysis of 155 patients in the Moscow Region who were examined at the Central Clinical Hospital of the Russian Academy of Sciences during the first wave of the pandemic (FebruaryJuly, 2020). The inclusion criteria were a positive PCR test and typical, computed tomographic findings of viral pneumonia in the form of ground-glass opacities. A clinical correlation analysis was performed in four groups of patients: (1) those who were not on mechanical ventilation, (2) those who were on mechanical ventilation, and (3) those who subsequently recovered or (4) died. The correlation analysis also considered confounding comorbidities (diabetes, metabolic syndrome, hypertension, etc.). The immunological status of the patients was examined (levels of immunoglobulins of the M, A, G classes and their subclasses, as well as the total immunoglobulin level) using an original SARS-CoV-2 antibody ELISA kit. The ELISA kit was developed using linear S-protein RBD-SD1 and NTD fragments, as well as the N-protein, as antigens. These antigens were produced in the prokaryotic E. coli system. Recombinant RBD produced in the eukaryotic CHO system (RBD CHO) was used as an antigen representing conformational RBD epitopes. The immunoglobulin A level was found to be the earliest serological criterion for the development of a SARS-CoV-2 infection and it yielded the best sensitivity and diagnostic significance of ELISA compared to that of class M immunoglobulin. We demonstrated that the seroconversion rate of early N-protein-specific IgM and IgA antibodies is comparable to that of antibodies specific to RBD conformational epitopes. At the same time, seroconversion of SARS-CoV-2 N-protein-specific class G immunoglobulins was significantly faster compared to that of other specific antibodies. Our findings suggest that the strong immunogenicity of the RBD fragment is for the most part associated with its conformational epitopes, while the linear RBD and NTD epitopes have the least immunogenicity. An analysis of the occurrence rate of SARS-CoV-2-specific immunoglobulins of different classes revealed that RBD- and N-specific antibodies should be evaluated in parallel to improve the sensitivity of ELISA. An analysis of the immunoglobulin subclass distribution in sera of seropositive patients revealed uniform induction of N-protein-specific IgG subclasses G1G4 and IgA subclasses A1A2 in groups of patients with varying severity of COVID-19. In the case of the S-protein, G1, G3, and A1 were the main subclasses of antibodies involved in the immune response.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

COVID-19 in Russia: Clinical and Immunological Features of the First-Wave Patients

et al. 2021

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“…16 Study from Chen et al, 2020 shown the level of plasma CRP was positively correlated to the severity of COVID-19 and study from Ahnac et al found that the CRP level at administration represent a simple and independent factor that ca be useful for early detection of severity COVID-19. 17,18…”

Section: Discussionmentioning

confidence: 99%

C-reactive protein as the marker of COVID-19 severity at Sanjiwani general hospital, Gianyar, Bali in 2020

Ulandari

Widyaningsih²

2021

Int J Res Med Sci

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Background: Coronavirus disease-2019 (COVID-19) is a novel coronavirus type infection disease that was first reported at Wuhan city, Hubei province, China in December 2019. Cases of COVID-19 in Indonesia were increasing, reaching up to 287,008 confirmed cases on 30th September 2020. Sanjiwani general hospital Gianyar, Bali, one of the COVID-19 referral hospital at Gianyar, Bali, has treated as many as 149 confirmed COVID-19 cases from August to October 2020. The most significant laboratory parameter associated with COVID-19 severity was C-reactive protein (CRP) and neutrophil to lymphocyte ratio (NLR).Methods: This study is a descriptive cross-sectional study. Data were gathered through secondary data from the medical records using the total sampling method. Descriptive analyses were performed to describe the samples characteristics and to calculate the mean CRP level. Meanwhile, the chi-square test was done to investigate the association between CRP level and the severity level of COVID-19. The result is considered statistically significant if the p value is <0.05Results: Most of the samples are >60 years old (24.4%), female (56.6%), and have diabetes mellitus as their comorbid (46,7%). The mean CRP level is 8.9 mg/L. CRP level >8.9 mg/l significantly affects COVID-19 patients’ severity with the p value of 0.000 (p<0.005). The higher the initial CRP level of COVID-19 patients, the higher the severity level will be.Conclusions: There is an association between the increased CRP level at the beginning of hospital admission and the severity of COVID-19 patients.

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“…C-reactive protein, an acute-phase inflammatory protein, reported to be used as a predictor of severity of COVID-19 infection [ 28 ]. Another striking observation in our study is that the diabetic subset had higher admission CRP levels than the total cohort (74.7 mg/L vs 50.65mg/L).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of simple and cost-effective immuno- haematological markers to predict outcome in hospitalized severe COVID-19 patients, with a focus on diabetes mellitus - A retrospective study in Andhra Pradesh, India

Ramesh

Reddy

Rajesh

et al. 2021

Diabetes & Metabolic Syndrome: Clinical Research & Revi

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Background and aims COVID-19 pandemic has strained the health infrastructure globally, providing an opportunity to identify cost-effective biomarkers. We aimed to identify simple hematological prognostic markers in hospitalized severe COVID-19 patients with and without diabetes. Methods Retrospective study of RT-PCR confirmed hospitalized severe COVID-19 patients (total: n = 154 patients, including diabetic subset n = 57) were analyzed. Clinically applicable cut-offs were derived using receiver operating characteristic (ROC) curve analysis for total leucocyte count (TLC), absolute neutrophil count (ANC), neutrophil lymphocyte ratio (NLR), and derived neutrophil lymphocyte ratio (dNLR) in order to prognosticate the outcome. Results Among 154 severe COVID-19 patients, significant association with mortality was seen with respect to TLC(p < 0.001), ANC (p < 0.001), NLR(p < 0.001) and dNLR(p < 0.001). In the total cohort, applicable cut-offs based on ROC curve in predicting outcome were, for TLC 8950 cells/mm 3 (area under curve (AUC)-0.764, odds ratio (OR)-7.53), ANC 7679 cells/mm 3 (AUC-0.789, OR-8.14), NLR 5.13 (AUC-0.741, OR-4.77), dNLR 3.44 (AUC -0.741, OR-4.43) respectively.In diabetic subset, the cut-offs for TLC was 8950 cells/mm 3 (AUC -0.762, OR-14.9), ANC 6510 cells/mm 3 (AUC -0.773, OR-16.8), NLR 5.13(AUC -0.678, OR-6) and dNLR 3.25(AUC -0.685, OR-4.7) respectively. Conclusions In severe COVID-19 patients irrespective of diabetes, a simple, applicable total leucocyte count cut-off, 8950 cells/mm 3 , together with easily derived cut-offs for ANC, NLR, dNLR may serve as cost-effective prognosticators of clinical outcome. A normal TLC may be misleading in the intensive care and the above applicable cut-off for TLC serves as an early warning tool for high-risk identification and better in-hospital management. Even with similar or lower cut-offs, diabetics had a higher mortality.

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C-reactive protein as an early predictor of COVID-19 severity

Cited by 109 publications

References 27 publications

COVID-19 in Russia: Clinical and Immunological Features of the First-Wave Patients

COVID-19 in Russia: Clinical and Immunological Features of the First-Wave Patients

C-reactive protein as the marker of COVID-19 severity at Sanjiwani general hospital, Gianyar, Bali in 2020

Evaluation of simple and cost-effective immuno- haematological markers to predict outcome in hospitalized severe COVID-19 patients, with a focus on diabetes mellitus - A retrospective study in Andhra Pradesh, India

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