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15 april 2020
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CRP and pulmonary findings correlate in COVID-19

A significant increase of C-reactive protein (CRP) has been reported with concentrations on average 30-50 mg/L1,2,3 from patients with COVID-19. It seems that the patients with severe disease symptoms have significantly higher CRP levels. For example a study reported, patients with mild symptoms had on average CRP level of 19 mg/L and patients with more severe symptoms CRP level of 39 mg/L1.

The pulmonary findings from CT scans of COVID-19 patients are similar to H1N1 influenza4. In both viral pneumonias CRP level correlates with the severity of pathological findings significantly. The severity of lung CT findings in COVID-19 is also associated with the disease progression5,6. Lung lesions are also more commonly seen in patients aged > 45 years compared to patients < 18 years7. Furthermore, patients with low oxygen saturation (SpO2 < 90%) had significantly higher CRP median (82 mg/L) compared to patients with oxygen saturation SpO2 > 90% (median 11 mg/L)8, suggesting that patients with more severe lung damage have higher CRP values. In conclusion, CRP correlates well with the severity of the symptoms of patients with COVID-19 and therefore it is suitable in assessing patient´s condition together with other clinical findings.

References:
  1. Gao et al. 2020 Diagnostic Utility of Clinical Laboratory Data Determinations for Patients with the Severe COVID-19. J Med Virol. 2020 Mar 17. doi: 10.1002/jmv.25770.
  2. Chen et al. 2020. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020; 395: 507–13. https://doi.org/10.1016/S0140-6736(20)30211-7
  3. Mo et al. 2020. Clinical characteristics of refractory COVID-19 pneumonia in Wuhan, China. Clin Infect Dis. 2020 Mar 16. doi: 10.1093/cid/ciaa270.
  4. Feng et al. The relationship between pulmonary HRCT findings and peripheral blood immunological parameters in adults with H1N1 influenza. Radiology of Infectious Diseases 2016; 3:60-65.
  5. Song F, Shi N, Shan F, et al. Emerging coronavirus 2019-nCoV pneumonia. Radiology 2020 Feb 6 [Epub ahead of print]
  6. Pan Y, Guan H, Zhou S, et al. Initial CT findings and temporal changes in patients with the novel coronavirus pneumonia (2019-nCoV): a study of 63 patients in Wuhan, China. Eur Radiol 2020 Feb 13.
  7. Chen et al. High-resolution computed tomography manifestations of COVID-19 infections in patients of different ages. European Journal of Radiology. 24.3.2020. DOI:https://doi.org/10.1016/j.ejra... et al. Clinical Features of 69 Cases with Coronavirus Disease 2019 in Wuhan, China. Clin Infect Dis. 2020 Mar 16. doi: 10.1093/cid/ciaa272.
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