Association between C-Reactive protein at time of presentation and severity of COVID-19 pneumonitis and can C-Reactive protein improve referral system from periphery?

Abstract

Introduction: The world has been under one vicious COVID-19 wave after the other for nearly 2 years, and the battle is still on. We know that the majority of serious infections have significant high-resolution computed tomography (HRCT) changes; a predictor for them would be a vital tool in this battle! Aims and Objectives: The study aimed to assess the correlation between C-reactive protein (CRP) at the time of presentation and HRCT score in patients with severe COVID-19 infection. Methods: In this prospective, single-center study of 121 patients with severe COVID-19 infection in a tertiary COVID-19 care center. Patients were assessed for the relationship between CRP levels and chest radiography in COVID-19 patients. Results: In patients who survived in severe COVID-19 infection, CRP on admission had a significant correlation with HRCT score with P = 0.019, and in patients who did not survive, CRP on admission had a significant correlation with HRCT score with P = 0.005. CRP at day 5 was also significantly correlated to HRCT score with P = 0.035 in survivors and P = 0.001 in patients who did not survive. Conclusion: In centers where HRCT chest is not available or financial resources are a major concern, we suggest early CRP, repeated after 3–5 days, could be a very useful prognostic factor for significant lung involvement during the course of illness. This, in turn, could be a very useful tool in determining a need for admission, referral to higher centers, or more intensive therapy early on.

Keywords

• covid-19
• c-reactive protein
• high-resolution computed tomography
• predictor