DOI: https://dx.doi.org/10.18203/2320-6012.ijrms20221012
Published: 2022-04-26

Correlation between chest CT severity score and C-reactive protein in COVID-19 positive patients admitted in a tertiary care hospital: a retrospective study

Prathibha Nag, Shashibhushan Bangalore Lakshamanamurthy, Arun B. J.

Abstract


Background: COVID-19 has developed into a worldwide pandemic. The early identification of patients who will become severely ill could facilitate the allocation of the limited medical resources to patients in need of aggressive treatment. Aim of the current study was to determine the correlation between COVID-19 severity with inflammatory marker CRP and CT severity score on HRCT thorax

Methods: A retrospective observational study was done in 502 hospitalized COVID‑19 patients in a tertiary care hospital BMCRI, Bangalore from August 2021 to September 2021. Clinical and laboratory data of patients were collected. The correlation between clinical severity with chest CT score and CRP were determined by ANOVA test and independent sample t-test was applied among survivors and non survivors. Correlation between CTSS and CRP was analyzed by Pearson correlation analysis.

Results: In our present study we found that, out of 502 patients who fulfilled the inclusion criteria 158 patients (31.5%) were triaged as mild cases, 228 patients (45.4%) were moderate case, and 116 patients (23.1%) severe cases. There was statistical significance between CRP values and CTSS among the mild, moderate, severe cases (p<0.001). Both CTSS and CRP values had explicit association with clinical condition of patients. By using independent sample t-test we could derive that CRP and CTSS had strong and significant correlation with the disease severity and mortality. Pearson correlation analysis revealed strong positive correlation between CRP and CTSS in COVID-19 patients. Hence an increase in CRP caused an increase in CTSS with significant p values.

Conclusions: In our study we conclude that there is a strong positive clinical correlation between CRP and CTSS in COVID-19 patients reflecting disease severity and mortality.


Keywords


COVID-19, C-reactive protein, CT severity score

Full Text:

PDF

References


Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020; 395(10223):497-506.

Lieveld AW, Azijli K, Teunissen BP, van Haaften RM, Kootte RS, van den Berk IA, et al. Chest CT in COVID-19 at the ED: validation of the COVID-19 reporting and data system (CO-RADS) and CT severity score: a prospective, multicenter, observational study. Chest. 2021;159(3):1126-35.

Zeng F, Huang Y, Guo Y, Yin M, Chen X, Xiao L, et al. Association of inflammatory markers with the severity of COVID-19: a meta-analysis. Int J Infect Dis. 2020;96:467-74.

Bernheim A, Mei X, Huang M, Yang Y, Fayad ZA, Zhang N, et al. Chest CT findings in coronavirus disease-19 (COVID-19): relationship to duration of infection. Radiology. 2020;3:200463.

Liu F, Li L, Xu M, Wu J, Luo D, Zhu Y, et al. Prognostic value of interleukin-6, C-reactive protein, and procalcitonin in patients with COVID-19. J Clin Virol. 2020;127:104370.

Lio X, Zhou W, Yan X, Guo T, Wang B, Xia H, et al. Prognostic value of C-reactive protein in patients with coronavirus 2019. Clin Infect Dis. 2020;71(16): 2174-9.

Feketea GM, Vlacha V. The diagnostic significance of usual biochemical parameters in coronavirus disease 19 (COVID-19): albumin to globulin ratio and CRP to albumin ratio. Front Med. 2020;15:804.

Chang YC, Yu CJ, Chang SC, Galvin JR, Liu HM, Hsiao CH, et al. Pulmonary sequelae in convalescent patients after severe acute respiratory syndrome: evaluation with thin-section CT. Radiology. 2005; 236(3):1067-75.

Clinical Guidance for management of adult COVID-19 Pateints. Available at: https://covid.aiims.edu/ clinical-guidance-for-management-of-adult-covid-19-patients/. Accessed on 20 December 2021.

Chen W, Zheng KI, Liu S, Yan Z, Xu C, Qiao Z. Plasma CRP level is positively associated with the severity of COVID-19. Ann Clin Microbiol Antimicrob. 2020;19(1):1-7.

Zhang J, Meng G, Li W, Shi B, Dong H, Su Z, et al. Relationship of chest CT score with clinical characteristics of 108 patients hospitalized with COVID-19 in Wuhan, China. Respir Res. 2020; 21(1):1.

Koozi H, Lengquist M, Frigyesi A. C-reactive protein as a prognostic factor in intensive care admissions for sepsis: a Swedish multicenter study. J Critic Care. 2020;56:73-9.

Kurri N, Tyagi B, Singhal E, Gupta N, Agarwal AK, Gupta V, et al. Assessing the impact of inflammatory markers and CT severity score on disease severity of COVID-19 patients admitted to ICU at a tertiary hospital. J Assoc Physic India. 2021;69(6):11-2.

Xiong Y, Sun D, Liu Y, Fan Y, Zhao L, Li X, et al. Clinical and high-resolution CT features of the COVID-19 infection: comparison of the initial and follow-up changes. Invest Radiol. 2020.

Marimuthu AK, Anandhan M, Sundararajan L, Chandrasekaran J, Ramakrishnan B. Utility of various inflammatory markers in predicting outcomes of hospitalized patients with COVID-19 pneumonia: A single-center experience. Lung India. 2021;38(5):448.

Bilgir O, Bilgir F, Calan M, Calan OG, Yuksel A. Comparison of pre-and post-levothyroxine high-sensitivity c-reactive protein and fetuin-a levels in subclinical hypothyroidism. Clinics. 2015;70:97-101.

Soy M, Keser G, Atagündüz P, Tabak F, Atagündüz I, Kayhan S. Cytokine storm in COVID-19: pathogenesis and overview of anti-inflammatory agents used in treatment. Clin Rheumatol. 2020; 39(7):2085-94.

Jamilloux Y, Henry T, Belot A, Viel S, Fauter M, El Jammal T, et al. Should we stimulate or suppress immune responses in COVID-19? Cytokine and anti-cytokine interventions. Autoimmun Rev. 2020;19(7): 102567.

Matsumoto H, Kasai T, Sato A, Ishiwata S, Yatsu S, Shitara J, et al. Association between C-reactive protein levels at hospital admission and long-term mortality in patients with acute decompensated heart failure. Heart Vessels. 2019;34(12):1961-8.

Xu Z, Shi L, Wang Y, Zhang J, Huang L, Zhang C, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020;8(4):420-2.

Chung M, Bernheim A, Mei X, Zhang N, Huang M, Zeng X, et al. CT imaging features of 2019 novel coronavirus (2019-nCoV). Radiology. 2020;295(1): 202-7.

Pan F, Ye T, Sun P, Gui S, Liang B, Li L, et al. Time course of lung changes on chest CT during recovery from 2019 novel coronavirus (COVID-19) pneumonia. Radiology. 2020.

Jn W, Shen J. Emphasis and scientific evaluate the role of CT in the diagnosis and treatment of novel coronavirus pneumonia. J Dalian Med Univ. 2020; 42(1):1-4.