Predictive value of C-reactive protein on hospital admission and mechanical ventilation requirement in adults hospitalized for COVID-19
DOI:
https://doi.org/10.31053/1853.0605.v81.n1.41799Keywords:
COVID-19, Reactive C protein;, mechanical ventilation, PCRAbstract
Introduction: During the COVID-19 pandemic, patients with worse evolution presented clinical deterioration 7-10 days after the onset of symptoms, which suggests that the inflammatory response could participate in the pathophysiology of the disease. The objective of this study was to evaluate the association between plasma C-reactive protein (PCr) on hospital admission and mechanical ventilation requirement during hospitalization in adults with COVID-19.
Methods: Retrospective, observational cohort at a private center in the province of Buenos Aires. Hospitalized adults diagnosed with COVID-19 by nasal swab using real time transcription polymerase chain reaction or antigen were included. The primary outcome was the association between high plasma PCr values on hospital admission (≥8 mg/L) and mechanical ventilation requirement during hospitalization.
Results: Of the 1,242 patients enrolled, 19.4% required mechanical ventilation and 11.7% died during the hospitalization. The PCr of the patients who required mechanical ventilation was higher than that of those who did not require mechanical ventilation (9.45 [5.20-18.70] mg/L vs 4.95 [1.80-10.70] mg/L; p < 0.01). PCr analyzed as a continuous variable (OR = 1.39; 95%CI 1.21-1.60; p < 0.001) and as a categorical variable (≥8 mg/L) (OR = 2.66; 95%CI 2.19 -3.78, p < 0.001) presented a significant association with the requirement of mechanical ventilation during hospitalization. Additionally, a significant association was found between PCr and in-hospital mortality.
Conclusion: Plasma PCr on hospital admission could predict clinical evolution in adult patients hospitalized for COVID-19.
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Prete M, Favoino E, Catacchio G, Racanelli V, Perosa F. SARS-CoV-2 Inflammatory Syndrome. Clinical Features and Rationale for Immunological Treatment. Int J Mol Sci. 2020 May 10;21(9):3377. doi: 10.3390/ijms21093377. 2. Sohrabi C, Alsafi Z, O’Neill N, Khan M, Kerwan A, Al-Jabir A, et al. World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19). Int J Surg. 2020;76: 71–76.
Sohrabi C, Alsafi Z, O’Neill N, Khan M, Kerwan A, Al-Jabir A, et al. World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19). Int J Surg. 2020;76: 71–76.
Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW; the Northwell COVID-19 Research Consortium; Barnaby DP, Becker LB, Chelico JD, Cohen SL, Cookingham J, Coppa K, Diefenbach MA, Dominello AJ, Duer-Hefele J, Falzon L, Gitlin J, Hajizadeh N, Harvin TG, Hirschwerk DA, Kim EJ, Kozel ZM, Marrast LM, Mogavero JN, Osorio GA, Qiu M, Zanos TP. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. JAMA. 2020 May 26;323(20):2052-2059. doi: 10.1001/jama.2020.6775. Erratum in: JAMA. 2020 May 26;323(20):20985.
Manson JJ, Crooks C, Naja M, Ledlie A, Goulden B, Liddle T, Khan E, Mehta P, Martin-Gutierrez L, Waddington KE, Robinson GA, Ribeiro Santos L, McLoughlin E, Snell A, Adeney C, Schim van der Loeff I, Baker KF, Duncan CJA, Hanrath AT, Lendrem BC, De
Soyza A, Peng J, J'Bari H, Greenwood M, Hawkins E, Peckham H, Marks M, Rampling T, Luintel A, Williams B, Brown M, Singer M, West J, Jury EC, Collin M, Tattersall RS. COVID-19-associated hyperinflammation and escalation of patient care: a retrospective longitudinal cohort study. Lancet Rheumatol. 2020 Oct;2(10):e594-e602. doi: 10.1016/S2665-9913(20)30275-7.
Feng X, Li S, Sun Q, Zhu J, Chen B, Xiong M, Cao G. Immune-Inflammatory Parameters in COVID-19 Cases: A Systematic Review and Meta-Analysis. Front Med (Lausanne). 2020 Jun 9;7:301. doi: 10.3389/fmed.2020.00301.
RECOVERY Collaborative Group; Horby P, Lim WS, Emberson JR, Mafham M, Bell JL, Linsell L, Staplin N, Brightling C, Ustianowski A, Elmahi E, Prudon B, Green C, Felton T, Chadwick D, Rege K, Fegan C, Chappell LC, Faust SN, Jaki T, Jeffery K, Montgomery A, Rowan K, Juszczak E, Baillie JK, Haynes R, Landray MJ. Dexamethasone in Hospitalized Patients with Covid-19. N Engl J Med. 2021 Feb 25;384(8):693-704. doi: 10.1056/NEJMoa2021436.9.
Luo X, Zhou W, Yan X, Guo T, Wang B, Xia H, Ye L, Xiong J, Jiang Z, Liu Y, Zhang B, Yang W. Prognostic Value of C-Reactive Protein in Patients With Coronavirus 2019. Clin Infect Dis. 2020 Nov 19;71(16):2174-2179. doi: 10.1093/cid/ciaa641.
Wang G, Wu C, Zhang Q, Wu F, Yu B, Lv J, Li Y, Li T, Zhang S, Wu C, Wu G, Zhong Y. C-Reactive Protein Level May Predict the Risk of COVID-19 Aggravation. Open Forum Infect Dis. 2020 Apr 29;7(5):ofaa153. doi: 10.1093/ofid/ofaa153.
Prasetya IB, Cucunawangsih, Lorens JO, Sungono V, El-Khobar KE, Wijaya RS. Prognostic value of inflammatory markers in patients with COVID-19 in Indonesia. Clin Epidemiol Glob Health. 2021 Jul-Sep;11:100803. doi: 10.1016/j.cegh.2021.100803. 12.
Alburqueque-Melgarejo, J., Roque-Quezada, J. C., Virú Flores, H. M., De Celis Massa, V. E., la Cruz-Vargas, D., Jhony, A. Utilidad de la proteína C-reactiva para determinar la gravedad de infección por SARS-CoV-2 en Perú. Rev Chilena Infectol. 2023; 40 (2): 85-93.
Ahnach M, Zbiri S, Nejjari S, Ousti F, Elkettani C. C-reactive protein as an early predictor of COVID-19 severity. J Med Biochem. 2020 Oct 2;39(4):500-507. doi: 10.5937/jomb0-27554. 16.
Liu F, Li L, Xu M, Wu J, Luo D, Zhu Y, Li B, Song X, Zhou X. Prognostic value of interleukin-6, C-reactive protein, and procalcitonin in patients with COVID-19. J Clin Virol. 2020 Jun;127:104370. doi: 10.1016/j.jcv.2020.104370.
Chow A, Aung AH, Tin G, Ooi C-K. C-Reactive Protein (CRP) levels in influenza and other respiratory viral infections. Int J Infect Dis. 2020;101: 518–519.
Sociedad Argentina De Terapia Intensiva. Generalidades de la ventilación mecánica: sección IV, respiratorio. En: Sociedad Argentina De Terapia Intensiva. Terapia Intensiva. 4º ed. Buenos Aires: Editorial Médica Panamericana; 2007. p. 186-208.
Peduzzi P, Concato J, Kemper E, Holford TR, Feinstein AR. A simulation study of the number of events per variable in logistic regression analysis. J Clin Epidemiol. 1996 Dec;49(12):1373-9. doi: 10.1016/s0895-4356(96)00236-3.
Gandino IJ, Padilla MJ, Carreras M, Caballero V, López Griskan S, Carlos J, Ametla Y, Borodowski H, Ladelfa J, Themines S, Basta MC, Presas JL. índice linfocito proteína C reactiva en COVID-19: una herramienta poco explorada [Lymphocyte-to-C-reactive protein ratio in COVID-19: an unexplored tool]. Medicina (B Aires). 2022;82(5):689-694.
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