C-Reactive Protein Level May Predict the Risk of COVID-19 Aggravation

Wang, Guyi; Wu, Chenfang; Zhang, Quan; Wu, Fang; Yu, Bo; Lv, Jianlei; Li, Yiming; Li, Tiao; Zhang, Siye; Wu, Chao; Wu, Guobao; Zhong, Yanjun

doi:10.1093/ofid/ofaa153

Cited by 251 publications

(267 citation statements)

References 14 publications

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“…High CRP values have now become synonymous with severe COVID-19 infection among adults as seen in majority of the studies. 28,29,30 Mean CRP in our study was found to be 10.98mg/dl. CRP as high as 153.77mg/dl were seen in asymptomatic children while CRP as low as 4.59mg/dl was seen in the severe case suggesting a milder immune response.…”

Section: Discussionsupporting

confidence: 41%

Epidemiological and clinical characteristics of COVID-19 in Indian children in the initial phase of the pandemic: A cross-sectional study

Sarangi

Reddy

Oswal

et al. 2020

Preprint

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Background: India saw the largest and the most stringent lockdown in the world when the number of COVID-19 cases reached around 550. With some early benefits in containing the surge and restricting the R0 of the virus, the current relaxation of lockdown norms has witnessed an exponential rise in positive cases. With scarcity of Pediatric data from the Indian subcontinent, early observations in the pandemic are pivotal in improving the understanding of physiologic behaviors, identifying risks, and guiding clinicians in assessing time-tested interventions and augmenting the awareness in the masses about the manifold clinical profiles of an evolving disease.Objective: To assess the epidemiological and clinical characteristics of children admitted with COVID-19 infection early in the pandemic.Study Design: A cross-sectional studyParticipants: Fifty children between one month and 18 years of age whose nasopharyngeal swab tested positive for SARS-CoV-2 by RT- PCR. Results: 28 (56%) children were male. 41 (82%) came from government declared containment zones with only one child having history of travel to affected area. Home overcrowding was observed in 33 (66%). Of the 50 children, 29 (58%) were asymptomatic while 20 (40%) and one (2%) had mild and moderate symptoms respectively. Fever, cough, and sore throat were the most common symptoms. 49 (98%) children had BCG scar. Leucopenia was seen in three (6%) only. Mean (SD) Neutrophil-Lymphocyte-Ratio (NLR) was 0.78 (0.48) while mean (SD) CRP was 10.98 (23.90). All 50 (100%) were cured. Conclusion: Our study reasserts the increasing pediatric burden of COVID-19 with all age groups affected and overcrowding as a risk factor for continued community transmission, thus beckoning that public health policies be directed to ensuring further preventive measures. It also re-iterates the milder disease pattern in children with COVID-19 in the initial phase of the pandemic with a high proportion of asymptomatic and mild illness. Though abnormal CRP values are synonymous with the illness in children; leucopenia may not be a consistent finding.

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Section: Discussionsupporting

confidence: 41%

Epidemiological and clinical characteristics of COVID-19 in Indian children in the initial phase of the pandemic: A cross-sectional study

Sarangi

Reddy

Oswal

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…Inflammatory markers, which have been widely used in diagnosing infections and predict disease progression [ 26 ], were investigated in several reports since the beginning of the COVID-19 pandemic. CRP, which is a protein produced by the liver, was found to be a relatively good predictor for the development of pneumonia in MERS-CoV infections [ 27 ] and has recently been found to be a valuable marker to anticipate the possibility of aggravation of non-severe adult COVID-19 patients, with an optimal threshold value of 26.9 mg/L [ 28 ]. This association is also replicated in our cohort, in which we found an above-normal CRP is associated with severe disease requiring ICU admission (OR = 21.1, 95% CI: 1.19–374) but was not associated with mortality ( p -value = 0.143).…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Outcome of Hospitalized COVID-19 Patients in a MERS-CoV Endemic Area

Barry¹,

Almohaya²,

Alhijji³

et al. 2020

JEGH

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Background: The Kingdom of Saudi Arabia (KSA) reported 170,639 cases and 1430 deaths from COVID-19 since the first case emerged in the country on March 2 through June 25, 2020. The objective of this report is to describe the characteristics and outcome observed among 99 hospitalized COVID-19 patients in the largest academic hospital in KSA, and assess co-infection with the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). Methods: This single-center case series data included select epidemiological, clinical, radiological features and laboratory findings of all confirmed hospitalized cases of COVID-19 in King Saud University Medical City (KSUMC), Riyadh, KSA, from March 22 until May 31, 2020, followed through June 6, 2020. We conducted retrospective analysis of listed data from 99 hospitalized patients and present characteristics and factors associated with severity in percentages and univariate odds ratios. Cases were confirmed using nasopharyngeal or throat swab by real-time Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and MERS-CoV by RT-PCR. Results: The 99 hospitalized COVID-19 patients included in this analysis constitute 16% of 632 positive SARS-CoV-2 among 6633 persons who were tested at the KSUMC (positivity rate, 9.4%). MERS-CoV PCR was negative in all 99 patients tested. The majority of these 99 hospitalized patients were males (66%), had a mean age of 44 years (range, 19–87), and a quarter (25.3%) were health care workers. Patients with comorbid conditions accounted for 52.5% of patients including the 8.1% who were asymptomatic; diabetes mellitus being the most frequent (31.3%), followed by hypertension (22.2%). The most common presenting symptoms were fever (67.7%), cough (60.6%), dyspnea (43.4%), upper respiratory symptoms (27.3%), fatigue (26.3%), diarrhea (19.2%) and loss of smell (9.1%). The clinical conditions among these 99 patients included upper respiratory tract infection (47.5%), abnormal chest X-ray, lymphopenia, high inflammatory markers a fifth (21%) of patients had moderate pneumonia, while 7% had severe pneumonia with 22.2% requiring admission to the intensive care unit and 12.1% died. Late presentation with severe disease, an abnormal chest X-ray, lymphopenia, high inflammatory markers (C-reactive protein, ferritin, and procalcitonin), and end organ damage (high creatinine or high aspartate aminotransferase) were predictors for admission to critical care unit or died. Conclusion: We observed no MERS-CoV co-infection in this early cohort of hospitalized COVID-19 patients who were relatively young, more than half had comorbid conditions, presented with fever and/or cough, an abnormal chest X-ray, lymphopenia, and high inflammatory markers. Given MERS-CoV endemicity in the country, co-monitoring of MERS-CoV and SARS-CoV-2 coinfection is critical.

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“…Meta-analysis of reports from China have also detailed C-reactive along with D-dimers, coagulation times, and lactate dehydrogenase; with lower platelet and lymphocyte counts a common nding in " Cytokine Storm Syndrome " in hospitalized patients with COVID-19 [13]. Others have also analysed CRP to look for association with the disease aggravation showed that CRP was signi cantly associated with aggravation of nonsevere COVID-19 patients [14]. Elevated levels of these in ammatory markers found in the our study group concur to these hypothesis.…”

Section: Discussionmentioning

confidence: 99%

Utility of routine haematological parameters and infectious biomarkers to assess the disease severity in COVID-19 positive patients, analysis and early trend from India

Singh¹,

Singh²,

Kelkar³

2020

Preprint

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Abstract Background and Objective- India has emerged as fifth worst hit nation by novel Corona virus pandemics in terms of total number of cases. Our literature on clinicopathological, hematopathological characterstics and trend is still miniscule. The study was conducted to assess utility of haematological parameters and infection biomarkers in identifying disease severity. Method- The test results for complete blood counts, Coagulation screen and inflammatory markers of covid 19 positive patients were recorded and analysed based on their admission to Intensive care units, High Dependency Units or Ward. Those parameters with significant differences between the groups werewere assessed by receiver operating curve and the best screening cut-off was selected. Results- 100 adults were analysed, area under the curve for total leukocyte count, Absolute neutrophil count, Neutrophil-to-Lymphocyte ratio was found >0.800, with p<0.05.The best cut off value obtained for TLC was 8100/cmm, with sensitivity and specificity of 91% and 62.5%; ANC – 6739/cmm, with 91.7% and 75% respectively; NLR - 6.9 with sensitivity and specificity 91.7% and 87.5% respectively. Haematological parameters of 33 paediatric patients studied separately and were well within normal physiological limits. Interpretation and conclusion- study suggests that in adults, using TLC, ANC and NLR, obtained from the basic preliminary workup may segregate patients requiring intensive care at the time of admission enabling risk stratification and guide intervention.

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C-Reactive Protein Level May Predict the Risk of COVID-19 Aggravation

Cited by 251 publications

References 14 publications

Epidemiological and clinical characteristics of COVID-19 in Indian children in the initial phase of the pandemic: A cross-sectional study

Epidemiological and clinical characteristics of COVID-19 in Indian children in the initial phase of the pandemic: A cross-sectional study

Clinical Characteristics and Outcome of Hospitalized COVID-19 Patients in a MERS-CoV Endemic Area

Utility of routine haematological parameters and infectious biomarkers to assess the disease severity in COVID-19 positive patients, analysis and early trend from India

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