Advances on C-Reactive Protein (CRP) in COVID-19

A recent review article by Luan et. al aimed to highlight the current and most recent studies with regard to the clinical significance of C-reactive protein (CRP) in severe COVID-19 and other viral associated illnesses. Severe coronavirus disease 2019 (COVID-19) can manifest as a viral-induced hyperinflammation with multiorgan dysfunction. It has been documented that severe COVID-19 is associated with higher levels of inflammatory mediators than in a mild disease, and tracking these biomarkers may allow early identification or even prediction of disease progression.

It is well known that C-reactive protein (CRP) is the acute-phase protein and the active regulator of host innate immunity, which is highly predictive of the need for mechanical ventilation and may guide escalation of treatment of COVID-19-related uncontrolled inflammation. CRP is normally lacking in viral infections, while adaptive immunity appears to be essential for COVID-19 virus clearance, and the macrophage activation syndrome may explain the high serum CRP contents and contribute to the disease progression. Nevertheless, for the assessment of host inflammatory status and identification of viral infection in other pathologies, such as bacterial sepsis, the acute-phase proteins including CRP, can provide more important information for guiding clinical diagnosis and antibiotic therapy.

The review article concluded that accumulating evidence have indicated CRP being markedly associated with the severity and prognosis of excessive inflammatory responses, such as cardiovascular disease, T2DM, hemorrhagic stroke, and sepsis in COVID-19 pneumonia. In this regard, CRP is not only an excellent biomarker of inflammation but also acts as a direct participant in the pathological process.

Reference

• Luan et al. Update Advances on C-Reactive Protein in COVID-19 and Other Viral Infections. Front. Immunol., 10 August 2021.
  Read the original article: https://doi.org/10.3389/fimmu.2021.720363