Prognostic Value of C-Reactive Protein in SARS-CoV-2 Infection: A Simplified Biomarker of COVID-19 Severity in Northern Ethiopia

Gebrecherkos, Teklay, Challa, Feyissa, Tasew, Geremew, Gessesse, Zekarias, Kiros, Yazezew, Gebreegziabxier, Atsbeha, Abdulkader, Mahmud, Desta, Abraham Aregay, Atsbaha, Ataklti Hailu, Tollera, Getachew, Abrahim, Saro, Urban, Britta ORCID: https://orcid.org/0000-0002-4197-8393, Schallig, Henk, Rinke de Wit, Tobias and Wolday, Dawit (2023) 'Prognostic Value of C-Reactive Protein in SARS-CoV-2 Infection: A Simplified Biomarker of COVID-19 Severity in Northern Ethiopia'. Infection and Drug Resistance, Vol 16, pp. 3019-3028.

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Abstract

Purpose
To evaluate the role of C-reactive protein (CRP) in predicting severe COVID-19 patients.

Methods
A prospective observational cohort study was conducted from July 15 to October 28, 2020, at Kuyha COVID-19 isolation and treatment center hospital, Mekelle City, Northern Ethiopia. A total of 670 blood samples were collected serially. SARS-CoV-2 infection was confirmed by RT-PCR from nasopharyngeal swabs and CRP concentration was determined using Cobas Integra 400 Plus (Roche). Data were analyzed using STATA version 14. P-value < 0.05 was considered statistically significant.

Results
Overall, COVID-19 patients had significantly elevated CRP at baseline when compared to PCR-negative controls [median 11.1 (IQR: 2.0– 127.8) mg/L vs 0.9 (IQR: 0.5– 1.9) mg/L; p=0.0004)]. Those with severe COVID-19 clinical presentation had significantly higher median CRP levels compared to those with non-severe cases [166.1 (IQR: 48.6– 332.5) mg/L vs 2.4 (IQR: 1.2– 7.6) mg/L; p< 0.00001)]. Moreover, COVID-19 patients exhibited higher median CRP levels at baseline [58 (IQR: 2.0– 127.8) mg/L] that decreased significantly to 2.4 (IQR: 1.4– 3.9) mg/L after 40 days after symptom onset (p< 0.0001). Performance of CRP levels determined using ROC analysis distinguished severe from non-severe COVID-19 patients, with an AUC value of 0.83 (95% CI: 0.73– 0.91; p=0.001; 77.4% sensitivity and 89.4% specificity). In multivariable analysis, CRP levels above 30 mg/L were significantly associated with an increased risk of developing severe COVID-19 for those who have higher ages and comorbidities (ARR 3.99, 95% CI: 1.35– 11.82; p=0.013).

Conclusion
CRP was found to be an independent determinant factor for severe COVID-19 patients. Therefore, CRP levels in COVID-19 patients in African settings may provide a simple, prompt, and inexpensive assessment of the severity status at baseline and monitoring of treatment outcomes.

Item Type:	Article
Subjects:	QU Biochemistry > Proteins. Amino Acids. Peptides > QU 55 Proteins WC Communicable Diseases > Virus Diseases > Viral Respiratory Tract Infections. Respirovirus Infections > WC 506 COVID-19
Faculty: Department:	Biological Sciences > Department of Tropical Disease Biology Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):	https://doi.org/10.2147/idr.s410053
SWORD Depositor:	JISC Pubrouter
Depositing User:	JISC Pubrouter
Date Deposited:	30 May 2023 08:02
Last Modified:	30 May 2023 08:02
URI:	https://archive.lstmed.ac.uk/id/eprint/22566

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