Department of Emergency, Eastern Campus, Renmin Hospital of Wuhan University, Wuhan, China.
Cancer Center, Renmin Hospital of Wuhan University, Wuhan, China.
Clin Infect Dis. 2020 Nov 19;71(16):2174-2179. doi: 10.1093/cid/ciaa641.
An elevated serum C-reactive protein (CRP) level was observed in most patients with coronavirus disease 2019 (COVID-19).
Data for COVID-19 patients with clinical outcome in a designated hospital in Wuhan, China, were retrospectively collected and analyzed from 30 January 2020 to 20 February 2020. The prognostic value of admission CRP was evaluated in patients with COVID-19.
Of 298 patients enrolled, 84 died and 214 recovered. Most nonsurvivors were male, older, or with chronic diseases. Compared with survivors, nonsurvivors showed significantly elevated white blood cell and neutrophil counts, neutrophil to lymphocyte ratio (NLR), systemic immune inflammation index (defined by platelet count multiplied by NLR), CRP, procalcitonin, and D-dimer and showed decreased red blood cell, lymphocyte, and platelet counts. Age, neutrophil count, platelet count, and CRP were identified as independent predictors of adverse outcome. The area under the receiver operating characteristic (ROC) curve (AUC) of CRP (0.896) was significantly higher than that of age (0.833), neutrophil count (0.820), and platelet count (0.678) in outcome prediction (all P < .05). With a cutoff value of 41.4, CRP exhibited sensitivity of 90.5%, specificity of 77.6%, positive predictive value of 61.3%, and negative predictive value of 95.4%. CRP was also an independent discriminator of severe/critical illness on admission with an AUC (0.783) comparable to age (0.828) and neutrophil count (0.729) (both P > .05).
In patients with COVID-19, admission CRP correlated with disease severity and tended to be a good predictor of adverse outcome.
大多数新型冠状病毒肺炎（COVID-19）患者的血清 C 反应蛋白（CRP）水平升高。
回顾性收集 2020 年 1 月 30 日至 2 月 20 日期间中国武汉某指定医院收治的 COVID-19 患者的临床结局数据，并进行分析。评估入院时 CRP 对 COVID-19 患者的预后价值。
共纳入 298 例患者，84 例死亡，214 例治愈。大多数死亡患者为男性，年龄较大或患有慢性病。与幸存者相比，非幸存者的白细胞和中性粒细胞计数、中性粒细胞与淋巴细胞比值（NLR）、全身免疫炎症指数（定义为血小板计数乘以 NLR）、CRP、降钙素原和 D-二聚体显著升高，而红细胞、淋巴细胞和血小板计数显著降低。年龄、中性粒细胞计数、血小板计数和 CRP 被确定为不良结局的独立预测因子。CRP（0.896）的受试者工作特征（ROC）曲线下面积（AUC）显著高于年龄（0.833）、中性粒细胞计数（0.820）和血小板计数（0.678）的 AUC（均 P <.05）。CRP 的截断值为 41.4，其灵敏度为 90.5%，特异性为 77.6%，阳性预测值为 61.3%，阴性预测值为 95.4%。CRP 也是入院时严重/危重症的独立鉴别指标，其 AUC（0.783）与年龄（0.828）和中性粒细胞计数（0.729）相当（均 P >.05）。
在 COVID-19 患者中，入院时 CRP 与疾病严重程度相关，且倾向于成为不良结局的良好预测指标。
