Cardiopulmonary MedicineBRIEF REPORT

C-reactive protein levels associated with COVID-19 outcomes in the United States

Jacob Lentner, OMS III; Taylor Adams, OMS IV; Valene Knutson, OMS III; Sarah Zeien, OMS IV; Hassan Abbas, OMS III; Ryan Moosavi, OMS III; Chris Manuel, OMS III; Thomas Wallace, MD; Adam Harmon, MD; Richard Waters, MD; Samuel Ledford, MD; Rajakrishnan Vijayakrishnan, MD; Nikhil Jagan, MD; Nezar Falluji, MD; Michael DelCore, MD; Curt Bay, PhD; and Sunny Jhamnani, MD
Notes and Affiliations
Notes and Affiliations

Received: April 5, 2021

Accepted: August 20, 2021

Published: September 29, 2021

  • Jacob Lentner, OMS III, 

    A.T. Still University – Kirksville College of Medicine, Kirksville, MO, USA

  • Taylor Adams, OMS IV, 

    A.T. Still University – Kirksville College of Medicine, Kirksville, MO, USA

  • Valene Knutson, OMS III, 

    A.T. Still University – Kirksville College of Medicine, Kirksville, MO, USA

  • Sarah Zeien, OMS IV, 

    A.T. Still University – Kirksville College of Medicine, Kirksville, MO, USA

  • Hassan Abbas, OMS III, 

    Midwestern University, Glendale, AZ, USA

  • Ryan Moosavi, OMS III, 

    Midwestern University, Glendale, AZ, USA

  • Chris Manuel, OMS III, 

    Midwestern University, Glendale, AZ, USA

  • Thomas Wallace, MD, 

    Department of Cardiovascular Medicine, CHI St. Vincent Infirmary, Chicago, IL, USA

  • Adam Harmon, MD, 

    Department of Cardiovascular Medicine, Sequoia Hospital, Redwood City, CA, USA

  • Richard Waters, MD, 

    Department of Cardiovascular Medicine, St. Joseph Medical Center, Stockton, CA, USA

  • Samuel Ledford, MD, 

    Department of Cardiovascular Medicine, CHI Memorial Hospital, Chattanooga, TN, USA

  • Rajakrishnan Vijayakrishnan, MD, 

    Department of Cardiovascular Medicine, St. Joseph Hospital and Medical Center, Phoenix, AZ, USA

  • Nikhil Jagan, MD, 

    Department of Pulmonary and Critical Care Medicine, CHI Health St. Francis, Grand Island, NE, USA

  • Nezar Falluji, MD, 

    Department of Cardiovascular Medicine, CHI St. Joseph Hospital, Lexington, KY, USA

  • Michael DelCore, MD, 

    Department of Cardiovascular Medicine, CHI Health Creighton University Medical Center – Bergan Mercy, Omaha, NE, USA

  • Curt Bay, PhD, 

    A.T. Still University, Mesa, AZ, USA

  • Sunny Jhamnani, MD, 

    Department of Cardiology, Chandler Regional Medical Center, Chandler, AZ, USA

Abstract

Context: COVID-19 caused a worldwide pandemic, and there are still many uncertainties about the disease. C-reactive protein (CRP) levels could be utilized as a prognosticator for disease severity in COVID-19 patients.

Objectives: This study aims to determine whether CRP levels are correlated with COVID-19 patient outcomes and length of stay (LoS).

Methods: A retrospective cohort study was conducted utilizing data obtained between March and May 2020. Data were collected by abstracting past medical records through electronic medical records at 10 hospitals within CommonSpirit Health. Patients were included if they had a positive COVID-19 test from a nasopharyngeal swab sample, and if they were admitted and then discharged alive or had in-hospital mortality and were ≥18 years. A total of 541 patients had CRP levels measured and were included in this report. Patient outcome and LoS were the endpoints measured.

Results: The 541 patients had their CRP levels measured, as well as the demographic and clinical data required for analysis. While controlling for body mass index (BMI), number of comorbidities, and age, the first CRP was significantly predictive of mortality (p<0.001). The odds ratio for first CRP indicates that for each one-unit increase in CRP, the odds of death increased by 0.007. For LoS, the first CRP was a significant predictor (p<0.001), along with age (p=0.002). The number of comorbidities also predicted LoS (p=0.007), but BMI did not. The coefficient for the first CRP indicates that, for each one-unit increase in CRP, LoS increased 0.003 days.

Conclusions: The results indicate that there is a positive correlation between the CRP levels of COVID-19 patients and their respective outcomes with regard to death and LoS.

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