Analysis of C-Reactive Protein as a predictor of coronavirus disease 2019

Abstract

BACKGROUND: This study was to analyze C-reactive protein (CRP) levels as a predictor of COVID-19 severity by using medical record data for COVID-19 patients who underwent treatment for the May-August 2020 period at Sayang Rakyat Hospital, Makassar.METHODS: The severity level was classified as mild, moderate, and severe illness based on the Guidelines for the Prevention and Control of COVID-19 by the Indonesian Ministry of Health. CRP levels were analyzed in all three groups. There were 162 patients consisting of 73 mild, 44 moderate, and 45 severe patients. The Kruskal Wallis Test shows there was a significant difference in CRP levels in the three patient groups, the highest was in the severe group (P<0.001).RESULTS: The post-hoc test showed that the CRP level in the moderately ill group was also significantly higher than the mild disease group, but lower than the severe group (P<0.001). The ROC curve analysis shows the CRP level with the cut-off value ≥10.0 mg/L in moderate (sensitivity 81.8%; specificity 43.8%, PPV 46.8%; NPV 80.0%) and ≥58.0 mg/L in severe (sensitivity 93.3%; specificity 81.2%, PPV 65.5%; NPV 96.9%). CRP levels increase significantly in response to injury, infection, and inflammation in severe disease.CONCLUSIONS: This shows that CRP is an inflammatory factor that plays an important role in worsening COVID-19. CRP can predict COVID-19 patient progression to moderate at a cut-off value ≥10 mg/L (sensitivity 81.8%, specificity 43.8%) and towards severe illness at the cut-off value ≥58 mg/L (sensitivity 93.3%, specificity 81.2%).

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