Prognostic value of C-reactive protein in patients with COVID-19

Luo, Xiaomin; Wei, Zhou; Yan, Xiaojie; Guo, Ting; Wang, Benchao; Xia, Hongxia; Yan, Lu; Xiong, Jie; Jiang, Zongping; Liu, Yu; Zhang, Bicheng; Yang, Wenchao

doi:10.1101/2020.03.21.20040360

Cited by 98 publications

(88 citation statements)

References 20 publications

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“…Higher CRP level has been reported as positively related to the severity of lung injury and COVID-19 severity by other researchers (12,13). However, in our study, no signi cant correlation between plasma CRP level and the risk of initial GI involvement has been found in this study ( Table 1).…”

Section: Correlation Between Clc and Initial Gi Involvementcontrasting

confidence: 74%

Virus discharge and initial gastrointestinal involvement are negatively associated with circulating lymphocyte count in COVID-19

Chen¹,

Zheng

Liu

et al. 2020

Preprint

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Abstract Background: It’s reported SARS-CoV-2 could transmit via gastrointestinal tract, with or without pulmonary symptoms. However, as far as we know, there is no convenient marker to predict the virus discharge in stool and initial gastrointestinal involvement of COVID-19.Aims: We aimed to investigate the biomarker predicting virus discharge in stool and initial gastrointestinal involvement of COVID-19, which may assist the clinicians to better combat and prevent COVID-19.Methods: The patients complained of initial gastrointestinal involvement, including vomiting, diarrhea, with or without respiratory symptoms, attending the Sixth People’s Hospital of Wenzhou, and the Second Affiliated Hospital of Wenzhou Medical University, were screened by qRT-PCR for SARS-CoV-2. The Confirmed COVID-19 patients without contaminated ingestion were all enrolled to investigate the association between circulating lymphocyte count and virus discharge, initial gastrointestinal involvement.Results: 76 COVID-19 patients were finally enrolled in this study (mean age 44.5, male 44.7%), with 24 (31.5%) complained of initial gastrointestinal symptoms. Significantly lower circulating lymphocyte count was found in the patients with positive results of qRT-PCR on stool (p = 0.012). Furthermore, when the circulating lymphocyte count increased from bottom tertile to the 2nd and 3rd tertiles, the risk of initial gastrointestinal involvement decreased by nearly 75% (OR = 0.25, 95% CI: 0.07, 0.98, p = 0.047), 83% (OR = 0.17, 95% CI: 0.05, 0.63, p = 0.008), adjusted for possible confounders.Conclusions: The circulating lymphocyte count is negatively associated with virus discharge in stool in COVID-19 patients, and the risk of initial gastrointestinal involvement also.

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Section: Correlation Between Clc and Initial Gi Involvementcontrasting

confidence: 74%

Virus discharge and initial gastrointestinal involvement are negatively associated with circulating lymphocyte count in COVID-19

Chen¹,

Zheng

Liu

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…Only in this way, can medical staffs make greater use of limited medical resources and reduce mortality. Recent clinical data have indicated that lymphocyte [9,10], CRP [11] and other factors may be related to the severity of COVID-19 [6]. However, the role of ferritin seems to be ignored even though clinical observation has discovered the abnormal ferritin levels in severe COVID-19 patients [6].…”

Section: Discussionmentioning

confidence: 99%

Elevated serum ferritin level effectively discriminates severity illness and predicts prognosis of COVID-19 patients

Cao

et al. 2020

Preprint

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During coronavirus disease 2019 (COVID-19) pandemic, medical resources in every country is in shortage. Efficacious indicators of discriminating severe illness and predicting outcome is in urgent need. We collected data and clinical records from 79 COVID-19 patients admitted between January 12, 2020 and February 21, 2020 at Wuhan Union hospital, China. Spearman’s correlation analysis, receiver operating characteristic (ROC) curve, logistic regression model, and Kaplan-Meier survival curves were employed in the analysis. Of 79 patients enrolled, 2 died in hospital, 8 were transferred to other hospitals, and 69 were discharged. Patients with elevated ferritin levels (> 200 ng/mL) had a higher incidence of severity illness when compared with those with normal ferritin levels (≤ 200 ng/mL) (50.0% vs 2.9%). In addition, severity illness manifested significantly higher level of ferritin as compared with non-severe ones (median 921.3 vs 130.7 ng/mL, p < 0.001). Furthermore, ferritin could effectively discriminate severity and non-severity, with an area under the ROC curve (AUC) reaching 0.873 (sensitivity 96%, specificity 70%), larger than that of age (0.697), C-reactive protein (0.730) and lymphocytes% (0.717). Combined model incorporating multivariate revealed a similar manner with ferritin alone (p = 0.981). Furthermore, elevated ferritin group showed longer viral clearance time (median 16 vs 6 days, p < 0.001) and in-hospital length (median 18 vs 10 days, p < 0.001). Our results suggest that ferritin could act as a simple and efficacious complementary tool to identify severe COVID-19 patients at early stage and predict their outcome. This indicator would provide guidance for subsequent clinical practice, alleviate the medical stress and reduce the mortality.

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“…More importantly, whether these changes and lipid pro les at admission can help to predict the clinical outcome of the COVID-19 patients remains unclear. C-reactive protein (CRP) is a common in ammatory marker, which increases in most patients with COVID-19 and is closely related to the severity of the disease [22]. And HDL and Apo-AI display pleiotropic properties including anti-oxidant and anti-in ammatory functions [9].Therefore, the ratio of CRP/HDL-C or CRP/ Apo-AI may re ect the balance between pro-in ammatory and anti-in ammatory process.…”

Section: Introductionmentioning

confidence: 99%

Changes in lipid metabolism in patients with severe COVID-19

Li¹,

Zhang²,

Dai³

et al. 2020

Preprint

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Background: Dyslipidemia plays an important role in the pathogenesis and evolution of critical illness, but limited information exists regarding the lipid metabolism of severe coronavirus disease 2019 (COVID-19) patients. The aim of this study was to investigate role of dyslipidemia in patients with severe COVID-19Methods: We retrospectively reviewed 216 severe COVID-19 patients with clarified outcomes (discharged or deceased), admitted to the West Court of Union Hospital in Wuhan, China, between February 1 and March 31, 2020. The dynamic changes of lipid profiles and their relationships with disease severity and clinical outcomes were analyzed.Results: A total of 216 severe COVID-19 patients, including 24 non-survivors and 192 survivors, were included in the final analyses. The levels of high-density lipoprotein cholesterol (HDL-C) and apolipoprotein AI (Apo-AI) on admission were significantly lower in non-survivors compared to survivors. During hospitalization, low-density lipoprotein cholesterol (LDL-C), total cholesterol(TC), HDL-C and Apo-AI were shown an increasing trend in survivors, but maintained lower levels or shown downward trend in non-survivors. The serum levels of HDL-C and Apo-AI were inversely correlated with C-reactive protein (CRP), length of hospital stay of survivors and disease severity. The receiver operating characteristic (ROC) curve analysis identified a CRP/ HDL-C ratio cut-off value of 62.54 as the predictor for in-hospital mortality (AUC=0.823, Sensitivity=83.3%, Specificity=70.8%). Logistic regression analysis demonstrated that hypertension, neutrophils-to-lymphocytes ratio(NLR), platelet count and high CRP/ HDL-C ratio (>62.54) were independent factors to predict in-hospital mortality.Conclusions: The results demonstrated that dyslipidemia was associated with the inflammatory response, disease severity and poor prognosis of COVID-19. High CRP/ HDL-C ratio may serve as an independently potential predictor for hospital mortality among patients with severe COVID-19.

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Prognostic value of C-reactive protein in patients with COVID-19

Cited by 98 publications

References 20 publications

Virus discharge and initial gastrointestinal involvement are negatively associated with circulating lymphocyte count in COVID-19

Virus discharge and initial gastrointestinal involvement are negatively associated with circulating lymphocyte count in COVID-19

Elevated serum ferritin level effectively discriminates severity illness and predicts prognosis of COVID-19 patients

Changes in lipid metabolism in patients with severe COVID-19

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