C reactive protein level may predict the risk of COVID-19 aggravation

Wang, Guyi; Wu, Chenfang; Zhang, Quan; Wu, Fang; Yu, Bo; Lv, Jianlei; Li, Yiming; Li, Tiao; Zhang, Siye; Wu, Chao; Wu, Guobao; Zhong, Yanjun

BACKGROUND: Clinical findings indicated that a fraction of Corona Virus Disease 2019 (COVID-19) patients diagnosed as mild early may progress to severe cases. However, it is difficult to distinguish these patients in the early stage. The present study was to describe the clinical characteristics of these patients, analyze related factors and explore predictive markers of the disease aggravation. METHODS: Clinical and laboratory data of non-severe adult COVID-19 patients in Changsha, China, were collected and analyzed on admission. A logistic regression model was adopted to analyze the association between the disease aggravation and related factors. Receiver operating characteristic curve (ROC) was utilized to analyze the prognostic ability of C-reactive protein (CRP). RESULTS: About 7.7% (16/209) non-severe adult COVID-19 patients progressed to severe cases after admission. Compared with non-severe patients, the aggravated patients had much higher levels of CRP (median, 43.8 mg/L [range: 12.3-101.9] vs 12.1 mg/L [range: 0.1-91.4]; P = 0.000). The regression analysis showed CRP was significantly associated with the aggravation of non-severe COVID-19 patients, with an area under the curves (AUC) of 0.844 (95% CI, 0.761 - 0.926) and the optimal threshold value of 26.9 mg/L. CONCLUSIONS: CRP could be a valuable marker to anticipate the possibility of aggravation of non-severe adult COVID-19 patients, with the optimal threshold value of 26.9 mg/L.