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April 15, 2020
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CRP and pulmonary findings correlate in COVID-19

A significant increase of C-reactive protein (CRP) has been reported with concentrations on average 30-50 mg/L1,2,3 from patients with COVID-19. It seems that the patients with severe disease symptoms have significantly higher CRP levels. For example a study reported, patients with mild symptoms had on average CRP level of 19 mg/L and patients with more severe symptoms CRP level of 39 mg/L1.

The pulmonary findings from CT scans of COVID-19 patients are similar to H1N1 influenza4. In both viral pneumonias CRP level correlates with the severity of pathological findings significantly. The severity of lung CT findings in COVID-19 is also associated with the disease progression5,6. Lung lesions are also more commonly seen in patients aged > 45 years compared to patients < 18 years7. Furthermore, patients with low oxygen saturation (SpO2 < 90%) had significantly higher CRP median (82 mg/L) compared to patients with oxygen saturation SpO2 > 90% (median 11 mg/L)8, suggesting that patients with more severe lung damage have higher CRP values. In conclusion, CRP correlates well with the severity of the symptoms of patients with COVID-19 and therefore it is suitable in assessing patient´s condition together with other clinical findings.

References:

  1. Gao et al. 2020 Diagnostic Utility of Clinical Laboratory Data Determinations for Patients with the Severe COVID-19. J Med Virol. 2020 Mar 17. doi: 10.1002/jmv.25770.
  2. Chen et al. 2020. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020; 395: 507–13. https://doi.org/10.1016/S0140-6736(20)30211-7
  3. Mo et al. 2020. Clinical characteristics of refractory COVID-19 pneumonia in Wuhan, China. Clin Infect Dis. 2020 Mar 16. doi: 10.1093/cid/ciaa270.
  4. Feng et al. The relationship between pulmonary HRCT findings and peripheral blood immunological parameters in adults with H1N1 influenza. Radiology of Infectious Diseases 2016; 3:60-65.
  5. Song F, Shi N, Shan F, et al. Emerging coronavirus 2019-nCoV pneumonia. Radiology 2020 Feb 6 [Epub ahead of print]
  6. Pan Y, Guan H, Zhou S, et al. Initial CT findings and temporal changes in patients with the novel coronavirus pneumonia (2019-nCoV): a study of 63 patients in Wuhan, China. Eur Radiol 2020 Feb 13.
  7. Chen et al. High-resolution computed tomography manifestations of COVID-19 infections in patients of different ages. European Journal of Radiology. 24.3.2020.
  8. Wang et al. Clinical Features of 69 Cases with Coronavirus Disease 2019 in Wuhan, China. Clin Infect Dis. 2020 Mar 16. doi: 10.1093/cid/ciaa272.
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