Correlation between Serum C-reactive protein Level with Severity of Covid19 Disease

Ebtihal  Alshaikh; Shereen Faisal  Abdelrahman; Suhair A. Ahmed; Gad Allah  Modawe; Rimaz  Gurashi

doi:10.52981/smlj.v10i2.2864

Ebtihal Alshaikh AlNeelain University, Faculty of Medical Laboratory Sciences, Khartoum, Sudan.
Shereen Faisal Abdelrahman AlNeelain University, Faculty of Medical Laboratory Sciences, Khartoum, Sudan.
Suhair A. Ahmed AlNeelain University, Faculty of Medical Laboratory Sciences, Khartoum, Sudan
Gad Allah Modawe Omdurman Islamic University, Faculty of Medicine and Health Sciences, Omdurman, Sudan.
Rimaz Gurashi AlNeelain University, Faculty of Medical Laboratory Sciences, Khartoum, Sudan

DOI: https://doi.org/10.52981/smlj.v10i2.2864

Keywords: Covid19, C- reactive protein

Abstract

Background: New coronavirus pneumonia (COVID-19) is a health emergency due to its high infectiousness and high case fatality in critically ill patients. C-reactive protein is one of the acute phase proteins and nonspecific markers of inflammation and has been found to correlate with disease severity and treatment of many infectious and non-infectious conditions. Objective: To correlate the serum level of C-reactive protein among COVID-19 Patients with disease severity.

Materials and Methods: this analytical cross-sectional study, was conducted at Aliaa specialized hospital, Omdurman city, Khartoum state, during the period from January to March 2021. Fifty patients diagnosed with covid-19 using RT-PCR, were enrolled in the study and then classified into severe patients and non-severe patients The CRP was measured by Particle enhanced immunoturbidimetric assay in Integra 400 fully automated instruments. The data were analyzed using SPSS version (25).

Results: Out of fifty patients, 42 patients were the non-severe group, and the remaining eight patients were the severe group. The average age was 66.45 years (ranging between 30 and 120 years), and 54% of patients were males and 36% were females. The most common coexisting conditions were Diabetes Mellitus and hypertension; 60% of patients were having a Diabetes Mellitus, and 52% of patients were having hypertension. The study's findings indicated that the mean CRP level of severe group was considerably higher than that of the non-severe group (365.75± 209.378), with a p-value of (0.002) and the results of the correlation analysis revealing a strong positive link between the severity of the disease and CRP (r=0.419**, p=0.002).

Conclusion: serum C-reactive protein has been found to correlate with disease severity.

References

1. Wang L. (2020) C-reactive protein levels in the early stage of COVID-19. Med Mal Infect;50:332-4.
2. Guyi Wang, Chenfang Wu, Quan Zhang, Fang Wu, Bo Yu, Jianlei Lv, Yiming Li, Tiao Li, Siye Zhang, Chao Wu, Guobao Wu, Yanjun Zhong, C-Reactive Protein Level May Predict the Risk of COVID-19 Aggravation, Open Forum Infectious Diseases, Volume 7, Issue 5, May 2020, ofaa153, https://doi.org/10.1093/ofid/ofaa153
3. Chen N, Zhou M, Dong X et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020;395:507–13.
4. Liu F, Li L, Xu M et al. Prognostic value of interleukin-6, C-reactive protein, and procalcitonin in patients with COVID-19. J Clin Virol 2020;127:104370.
5. Chen W, Zheng KI, Liu S, Yan Z, Xu C, Qiao Z. Plasma CRP level is positively associated with the severity of COVID-19. Ann Clin Microbiol Antimicrob 2020;19:18.
6. LuH, Stratton CW, Tang YW.Outbreak of pneumonia of unknown etiology in Wuhan, China: the mystery and the miracle. J Med Virol2020;92:401–2.
7. Dominic Stringer, Philip Braude, Phyo K Myint, et al The role of C-reactive protein as a prognostic marker in COVID-19 International Journal of Epidemiology, Volume 50, Issue 2, April 2021, Pages 420–429, https://doi.org/10.1093/ije/dyab012
8. Vasileva D, Badawi A. C-reactive protein as a biomarker of severe H1N1 influenza. Inflamm Res 2019;68:39–46.
9. HuiDS,AzharEI, MadaniTA, et al.The continuing 2019-nCoV epidemic threat of novel coronaviruses to global health - the latest 2019 novel coronavirus outbreak in Wuhan, China.Int J Infect Dis2020; 91:264–6.
10. Langford BJ , So M , Raybardhan S et al. Bacterial co-infection and secondary infection in patients with COVID-19: a living rapid review and meta-analysis. Clin Microbiol Infect 2020. https://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(20)30423-7/abstract (1 September 2020, date last accessed).
11. HuangC, Wang YLiX, et al.Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China.Lancet2020;395:497–506.
12. GuanWJ, NiZY, HuY, et al.Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med2020; 382:1708–20.
13. WangD, HuB, HuC, et al.Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. In press.
14. Tape TG. Interpreting Diagnostic Tests. University of Nebraska Medical Center; 2016. Available at: http://gim.unmc.edu/dxtests/. Accessed 7 March 2020
15. Potempa, LA, Rajab, IM, Hart, PC, et al. Insights into the use of C-reactive protein as a diagnostic index of disease severity in COVID-19 infections. Am J Trop Med Hyg 2020; 103(2): 561–563.
16. Esposito F, Matthes H, Schad F. Seven COVID-19 Patients Treated with C-Reactive Protein (CRP) Apheresis. Journal of clinical medicine. 2022;11(7):1956.
17. Mueller AA, Tamura T, Crowley CP, DeGrado JR, Haider H, Jezmir JL, et al. Inflammatory biomarker trends predict respiratory decline in COVID-19 patients. Cell Reports Medicine. 2020;1(8):100144.
18. Parimoo A, Biswas A, Baitha U, Gupta G, Pandey S, Ranjan P, et al. Dynamics of inflammatory markers in predicting mortality in COVID-19. Cureus. 2021;13(10).
19. Smilowitz NR, Kunichoff D, Garshick M, Shah B, Pillinger M, Hochman JS, et al. C-reactive protein and clinical outcomes in patients with COVID-19. European heart journal. 2021;42(23):2270-9.
20. Gao Y, Li T, Han M, Li X, Wu D, Xu Y, et al. Diagnostic utility of clinical laboratory data determinations for patients with the severe COVID-19 [published online March 17, 2020]. J Med Virol doi.10.
21. Mo P, Xing Y, Xiao Y, Deng L, Zhao Q, Wang H, et al. Clinical characteristics of refractory coronavirus disease 2019 in Wuhan, China. Clinical infectious diseases. 2021;73(11):e4208-e13.
22. Chen C, Wu D, Chen H, Yan W, Yang D, Chen G, et al. Yu H. Wang, H, Wang, T, Guo, W, Chen, J, Ding, C, Zhang, X, Huanf, J, Han, M, Li, S, Lu, X, Zhao, J & Li, S. 2020.
23. Tan C, Huang Y, Shi F, Tan K, Ma Q, Chen Y, et al. C‐reactive protein correlates with computed tomographic findings and predicts severe COVID‐19 early. Journal of medical virology. 2020;92(7):856-62.
24. Luo X, Zhou W, Yan X, Guo T, Wang B, Xia H, et al. Prognostic value of C-reactive protein in patients with coronavirus 2019. Clinical Infectious Diseases. 2020;71(16):2174-9.
25. Acar E, Demir A, Yıldırım B, Kaya MG, Gökçek K. The role of hemogram parameters and C‐reactive protein in predicting mortality in COVID‐19 infection. International journal of clinical practice. 2021;75(7):e14256.
26. Ali N. Elevated level of C‐reactive protein may be an early marker to predict risk for the severity of COVID‐19. Journal of medical virology. 2020.
27. Yitbarek GY, Walle Ayehu G, Asnakew S, Ayele FY, Bariso Gare M, Mulu AT, et al. The role of C-reactive protein in predicting the severity of COVID-19 disease: A systematic review. SAGE Open Medicine. 2021;9:20503121211050755.
28. Zahraa Kh. Muruh, Huda Rafaa Al-alwani, Noor N. Alhayani. Study the Association of Inflammatory Markers as CRP, LDH, D. Dimer and Ferritin with Severity of Covid19 Disease. Annals of R.S.C.B. (2021). Vol. 25, Issue 4, Pages. 2521 – 2534.