Singh Neelima, Kumar Randhir, Kumar Shailesh, Prasad Nidhi, Muni Sweta, Kumari Namrata
Infectious Disease, Indira Gandhi Institute of Medical Sciences, Patna, IND.
Cureus. 2024 Jan 2;16(1):e51499. doi: 10.7759/cureus.51499. eCollection 2024 Jan.
C-reactive protein (CRP) is a routine inflammation biomarker. Increased CRP levels are correlated with COVID-19. We found a marked reduction in CRP concentration on corticosteroid therapy, which in turn led to reduced mortality and duration of hospital stay.
In this retrospective cohort study, CRP levels were measured on admission and at 72 hours and compared between two groups of patients, with and without corticosteroid therapy. The study sample consisted of 105 RT-PCR-confirmed patients admitted to the ICU of the COVID ward. Out of the total patients, 57 received one or more doses of dexamethasone in addition to usual treatment, and 48 were given only usual care.
CRP at the time of admission was comparable for both groups. Also, a significant decrease in the CRP was noted in both groups 72 hours post-admission. Moreover, the decline was more marked in the steroid-administered group (CRP-baseline: 34.3mg/dL (+/-8.44), CRP at 72 hours 18.5mg/dL(+/-7.95) (p <0.00) compared to non-steroid group (CRP_baseline: 34.04mg/dL (+/-10.06), CRP at 72. Those with comorbidities were administered steroids (n=38, 66.7%) compared to those who were not (n=08, 16.7%). The average duration of hospital stay was less (5 to 7 days) in the corticosteroid-administered group compared to the other group (7 to 10 days).
Routine CRP tests can predict the outcome and treatment of severe coronavirus disease. Corticosteroid treatment in COVID-19 patients is associated with reduced CRP levels within 72 hours after therapy.
C反应蛋白(CRP)是一种常规炎症生物标志物。CRP水平升高与2019冠状病毒病(COVID-19)相关。我们发现皮质类固醇治疗可使CRP浓度显著降低,进而降低死亡率和缩短住院时间。
在这项回顾性队列研究中,对两组患者(接受和未接受皮质类固醇治疗)入院时及72小时时的CRP水平进行测量并比较。研究样本包括105例经逆转录聚合酶链反应(RT-PCR)确诊并入住COVID病房重症监护室(ICU)的患者。在所有患者中,57例除接受常规治疗外还接受了一剂或多剂地塞米松,48例仅接受常规护理。
两组患者入院时的CRP水平相当。此外,两组患者入院72小时后CRP均显著下降。而且,与未使用类固醇的组(CRP基线:34.04mg/dL(±10.06),72小时时CRP:[未给出具体数值])相比,使用类固醇的组CRP下降更为明显(CRP基线:34.3mg/dL(±8.44),72小时时CRP:18.5mg/dL(±7.95)(p<0.00))。有合并症的患者接受类固醇治疗的比例(n = 38,66.7%)高于无合并症的患者(n = 8,16.7%)。与另一组(7至10天)相比,接受皮质类固醇治疗的组平均住院时间较短(5至7天)。
常规CRP检测可预测重症冠状病毒病的预后和治疗效果。COVID-19患者接受皮质类固醇治疗与治疗后72小时内CRP水平降低有关。