High sensitivity C reactive protein level is associated with prognosis in patients with severe coronavirus disease 19 pneumonia

OBJECTIVES: The objective of the study is to describe the association of high-sensitivity C-reactive protein (hsCRP) in patients with severe coronavirus disease-19 (COVID-19) pneumonia and determine the relationship between hsCRP, prognosis, and other factors. METHODS: The hsCRP level and other clinical data of patients with severe COVID-19 pneumonia in Tongji Hospital were retrospectively reviewed. Unpaired t-test and Mann–Whitney test were used to compare difference in data between groups. Spearman analysis was used to analyze the correlation. RESULTS: Fifty-seven patients (25 male [43.9%] and 32 female [56.1%]) were included, and their condition was monitored for 28 days. The baseline hsCRP level was 35.5 ± 81.9 mg/L, and the hsCRP level of 49 patients increased (86.0%). Moreover, 45 (78.9%) patients recovered to ordinary/mild COVID-19 pneumonia and 12 (21.1%) progressed to critical COVID-19 pneumonia or continued having severe pneumonia. In the recovered group, the hsCRP level decreased significantly (P = 0.0023). The hsCRP level in the deteriorated group was significantly higher than that of the recovered group (P = 0.0019 and P = 0.0004). ΔhsCRP was significantly correlated with time from onset (P = 0.0151), prognosis (P = 0.0151), ΔD-dimer level (P = 0.0320), Δwhite blood cell count (P = 0.0018), and Δneutrophil count (P = 0.0061). CONCLUSIONS: Severe COVID-19 pneumonia is crucial to patient prognosis and manifests high hsCRP levels; decreased hsCRP level is associated with improved patient prognosis, but hsCRP level may not increase in patients with deteriorating conditions. Simultaneous increase in hsCRP and D-dimer levels may indicate risk for venous thromboembolism in COVID-19 patients.