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

Teklay Gebrecherkos, Feyissa Challa, Geremew Tasew, Zekarias Gessesse, Yazezew Kiros, Atsbeha Gebreegziabxier, Mahmud Abdulkader, Abraham Aregay Desta, Ataklti Hailu Atsbaha, Getachew Tollera, Saro Abrahim, Britta Urban, Henk Schallig, Tobias Rinke de Wit, Dawit Wolday

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)3019-3028
Number of pages10
JournalInfection and Drug Resistance
Volume16
DOIs
Publication statusPublished - 16 May 2023

Keywords

  • biomarker
  • COVID-19
  • CRP
  • SARS-CoV-2

Fingerprint

Dive into the research topics of 'Prognostic Value of C-Reactive Protein in SARS-CoV-2 Infection: A Simplified Biomarker of COVID-19 Severity in Northern Ethiopia'. Together they form a unique fingerprint.

Cite this