Serum C‐reactive protein greater than 75 mg/dL as an early available laboratory predictor of severe COVID‐19: A systematic review

Nazemi, Pershang; SeyedAlinaghi, SeyedAhmad; Azarnoush, Ayein; Mabadi, Avin; Khaneshan, Arezoo Salami; Salehi, Mohammadreza

doi:10.1002/iid3.1130

Cited by 3 publications

(1 citation statement)

References 52 publications

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“…During acute inflammatory responses to COVID-19, there is usually a rapid and significant increase in serum CRP levels. Elevated CRP fluctuation during hospitalization has been identified as the primary cause of ICU admission with a poor prognosis ( 41 ). Analysis revealed that critical patients have higher CRP levels, indicating a more significant inflammatory response than non-critical patients ( 13 ).…”

Section: Discussionmentioning

confidence: 99%

Clinical and immunological comparison of COVID-19 disease between critical and non-critical courses: a systematic review and meta-analysis

Hedayati-Ch,

Ebrahim-Saraie,

Bakhshi

2024

Front. Immunol.

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IntroductionAcute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), which appeared in 2019, has been classified as critical and non-critical according to clinical signs and symptoms. Critical patients require mechanical ventilation and intensive care unit (ICU) admission, whereas non-critical patients require neither mechanical ventilation nor ICU admission. Several factors have been recently identified as effective factors, including blood cell count, enzymes, blood markers, and underlying diseases. By comparing blood markers, comorbidities, co-infections, and their relationship with mortality, we sought to determine differences between critical and non-critical groups.MethodWe used Scopus, PubMed, and Web of Science databases for our systematic search. Inclusion criteria include any report describing the clinical course of COVID-19 patients and showing the association of the COVID-19 clinical courses with blood cells, blood markers, and bacterial co-infection changes. Twenty-one publications were eligible for full-text examination between 2019 to 2021.ResultThe standard difference in WBC, lymphocyte, and platelet between the two clinical groups was 0.538, -0.670, and -0.421, respectively. Also, the standard difference between the two clinical groups of CRP, ALT, and AST was 0.482, 0.402, and 0.463, respectively. The odds ratios for hypertension and diabetes were significantly different between the two groups. The prevalence of co-infection also in the critical group is higher.ConclusionIn conclusion, our data suggest that critical patients suffer from a suppressed immune system, and the inflammation level, the risk of organ damage, and co-infections are significantly high in the critical group and suggests the use of bacteriostatic instead of bactericides to treat co-infections.

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Section: Discussionmentioning

confidence: 99%

Clinical and immunological comparison of COVID-19 disease between critical and non-critical courses: a systematic review and meta-analysis

Hedayati-Ch,

Ebrahim-Saraie,

Bakhshi

2024

Front. Immunol.

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Biomarkers of High Flow Therapy Outcome in COVID-19 pneumonia: a single-center prospective study

Marín,

Aldás,

Galdeano

et al. 2024

Preprint

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Patients with acute hypoxemic respiratory failure (AHRF) due to COVID-19 undergoing High Flow Therapy (HFT) before intubation presented an increased risk of mortality when intubation was delayed. We designed a prospective study seeking biomarkers for early prediction of HFT failure. An analytical value in blood could be more stable than the ROX index since it will not depend on the vital signs that the patient presents at that moment. We defined HFT failure as the need to scale the treatment to Non-Invasive Positive Pressure Ventilation (NPPV). The needs were respiratory rate >25, oxygen saturation of <90% despite being on flow of 60 l·min-1 and FiO2 1 or levels of PaO2/FiO2 ratio <100mmHg. The all-treatment population included all subjects enrolled in the trial. 139 patients were enrolled after starting HFT. The Pearson chi-squared test was used to compare the main study outcomes. These included the incidence of intubation, the cumulative incidence of mortality at 30 days, the cumulative incidence of mortality at 1 year, and the composite outcome of intubation or death at the end of the trial. Kaplan-Meyer plot was used to illustrate the time to HFT failure. The Cox regression model was used to estimate the hazard ratio for HFT failure for all the parameters. All were measured or collected at baseline. Lower levels of bicarbonate, thrombocytopenia, and higher levels of C-reactive protein (CRP), lactate dehydrogenase (LDH), creatinine, and glucose are early blood biomarkers independently associated with HFT failure.SUMMARY AT A GLANCEHigher levels of C-reactive protein and lactate dehydrogenase in patients with COVID-19 pneumonia allow us to early detect patients requiring intubation with an apparent good response to high-flow oxygen therapy.

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Normalization of eosinophil count is predictive of oxygen weaning over the course of COVID-19 infection among hospitalized adults during the first wave of 2020 pandemic

Davido,

Jaffal,

Saleh-Mghir

et al. 2024

Front. Immunol.

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BackgroundUnderstanding COVID-19 outcomes remains a challenge. While numerous biomarkers have been proposed for severity at admission, limited exploration exists for markers during the infection course, especially for the requirement of oxygen therapy. This study investigates the potential of eosinophil count normalization as a predictor for oxygen weaning during the initial wave of the pandemic.MethodsA retrospective study was conducted between March and April 2020 (first wave) among adults admitted directly to a medicine ward. Biological abnormalities, including lymphocyte count, eosinophil count, and C-reactive protein (CRP), were gathered daily during the first week of admission according to oxygen level. In case of worsening, oxygen level was censored at 15 L/min. The primary aim was to assess whether eosinophil count normalization predicts a subsequent decrease in oxygen requirements.ResultsOverall, 132 patients were admitted, with a mean age of 59.0 ± 16.3 years. Of the patients, 72% required oxygen, and 20.5% were admitted to the intensive care unit after a median delay of 48 hours. The median CRP at admission was 79 (26–130) mg/L, whereas the eosinophil count was 10 (0–60)/mm3. Eosinophil count normalization (≥100/mm3) by day 2 correlated significantly with decreased oxygen needs (<2 L) with hazard ratio (HR) = 3.7 [1.1–12.9] (p = 0.04). Likewise, CRP < 80 mg/L was associated with reduced oxygen requirements (p < 0.001). Predictors, including underlying chronic respiratory disease, exhibited a trend toward a negative association (p = 0.06).ConclusionThe study highlights the relationship between eosinophil count and CRP, with implications for predicting oxygen weaning during COVID-19. Further research is warranted to explore the relevance of these biomarkers in other respiratory infections.

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Serum C‐reactive protein greater than 75 mg/dL as an early available laboratory predictor of severe COVID‐19: A systematic review

Cited by 3 publications

References 52 publications

Clinical and immunological comparison of COVID-19 disease between critical and non-critical courses: a systematic review and meta-analysis

Clinical and immunological comparison of COVID-19 disease between critical and non-critical courses: a systematic review and meta-analysis

Biomarkers of High Flow Therapy Outcome in COVID-19 pneumonia: a single-center prospective study

Normalization of eosinophil count is predictive of oxygen weaning over the course of COVID-19 infection among hospitalized adults during the first wave of 2020 pandemic

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