key: cord-0884535-tno34c5z
authors: Ali, Nurshad
title: Elevated level of C‐reactive protein may be an early marker to predict risk for severity of COVID‐19
date: 2020-06-09
journal: J Med Virol
DOI: 10.1002/jmv.26097
sha: 1ada93c4c8f2203027f33a0126509eaee45a6194
doc_id: 884535
cord_uid: tno34c5z

nan

Elevated level of C-reactive protein may be an early marker to predict risk for severity of COVID-19

To the Editor,

The outbreak of coronavirus disease-2019 (COVID- 19) is an emerging global health threat. The healthcare workers are facing challenges in reducing the severity and mortality of COVID-19 across the world.

Severe patients with COVID-19 are generally treated in the intensive care unit, while mild or non-severe patients treated in the usual isolation ward of the hospital. However, there is an emerging challenge that a small subset of mild or non-severe COVID-19 patients develops into a severe disease course. Therefore, it is important to early identify and give the treatment of this subset of patients to reduce the disease severity and improve the outcomes of COVID-19. Clinical studies demonstrated that altered levels of some blood markers might be linked with the degree of severity and mortality of patients with COVID-19. [1] [2] [3] [4] [5] Of these clinical parameter, serum C-reactive protein (CRP) has been found as an important marker that changes significantly in severe patients with COVID-19. 3 CRP is a type of protein produced by the liver that serves as an early marker of infection and inflammation. 6 In blood, the normal concentration of CRP is less than 10 mg/L; however, it rises rapidly within 6 to 8 hours and gives the highest peak in 48 hours from the disease onset. 7 Its half-life is about 19 hours 8 and its concentration decreases when the inflammatory stages end and the patient is healing. CRP preferably binds to phosphocholine expressed highly on the surface of damaged cells. 9 This binding makes active the classical complement pathway of the immune

Reference Note: Data are presented as mean (SD) or median (IQR). Severe: patients admitted to the ICU. P value indicates the mean or median difference of CRP levels between the severe and non-severe group. Abbreviations: GI, gastrointestinal; ICU, intensive care unit; IQR, interquartile range; NA, not available.

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