C-Reactive Protein Level May Predict the Risk of COVID-19 Aggravation

Abstract Background Clinical findings indicated that a fraction of coronavirus disease 2019 (COVID-19) patients diagnosed as mild early may progress to severe cases. However, it is difficult to distinguish these patients in the early stage. The present study aimed to describe the clinical characteristics of these patients, analyze related factors, and explore predictive markers of the disease aggravation. Methods Clinical and laboratory data of nonsevere adult COVID-19 patients in Changsha, China, were collected and analyzed on admission. A logistic regression model was adopted to analyze the association between the disease aggravation and related factors. The receiver operating characteristic curve (ROC) was utilized to analyze the prognostic ability of C-reactive protein (CRP). Results About 7.7% (16/209) of nonsevere adult COVID-19 patients progressed to severe cases after admission. Compared with nonsevere patients, the aggravated patients had much higher levels of CRP (median [range], 43.8 [12.3–101.9] mg/L vs 12.1 [0.1–91.4] mg/L; P = .000). A regression analysis showed that CRP was significantly associated with aggravation of nonsevere COVID-19 patients, with an area under the curve of 0.844 (95% confidence interval, 0.761–0.926) and an optimal threshold value of 26.9 mg/L. Conclusions CRP could be a valuable marker to anticipate the possibility of aggravation of nonsevere adult COVID-19 patients, with an optimal threshold value of 26.9 mg/L.

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Usefulness of Lymphocyte ratio and CRP Level for Early Detection of Surgical Site Infection Following spinal surgery

10.21203/rs.2.15566/v1 ◽

2019 ◽

Author(s):

Wenbo Wei ◽

Shajie Dang ◽

Dapeng Duan ◽

Liqun Gong ◽

Jue Wang ◽

...

Keyword(s):

Surgical Site Infection ◽

Spinal Surgery ◽

Operating Characteristic ◽

Characteristic Curve ◽

Area Under The Curve ◽

Site Infection ◽

C Reactive Protein ◽

Lymphocyte Ratio ◽

Reactive Protein ◽

Operating Characteristic Curve

Abstract Background: To investigate the significant laboratory markers for early diagnosis of surgical site infection after spinal surgery. And determine the diagnostic cut-off values of these markers Methods: A total of 67 patients participated in the study: 11 patients who developed surgical site infection after spinal surgery (SSI Group) and 56 patients were compared with the infected group in terms of age，gender, operating time and intraoperative blood loss (Non-SSI Group). The white blood cell (WBC) count , WBC differential , C-reactive protein (CRP) and erythrocyte sedimentation rate(ESR) were determined before and 1, 3 and 7 days postoperatively . Then, we determine the diagnostic cutoff for these markers by using the receiver operating characteristic curve. Results: The CRP, ESR and WBC were significantly higher in the SSI group at 3 and 7 days postoperatively. The lymphocyte ratio at 3 days postoperatively was significantly lower in the SSI Group. Using the receiver operating characteristic curve，lymphocyte ratio <11.5% at 3 days postoperatively (sensitivity 90.9%, specificity 75.4%, area under the curve [AUC] 0.919), and C-reactive protein level >26 mg/dL at 7 days postoperatively (sensitivity 90.9%, specificity 87.7%, area under the curve [AUC] 0.954) were the significant laboratory marker for early detection of SSI Conclusion: Lymphocyte ratio<11.5% at 3 days and C-reactive protein levels>26.5mg/dl at 7 days after spinal surgery are reliable markers of SSI.

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C-Reactive Protein Was an Early Predictor of Postoperative Infectious Complications After Pancreaticoduodenectomy for Pancreatic Cancer

International Surgery ◽

10.9738/intsurg-d-16-00171.1 ◽

2017 ◽

Vol 102 (5-6) ◽

pp. 258-266

Author(s):

Yosuke Atsumi ◽

Toru Aoyama ◽

Keisuke Kazama ◽

Masaaki Murakawa ◽

Manabu Shiozawa ◽

...

Keyword(s):

Pancreatic Cancer ◽

Predictive Value ◽

Characteristic Curve ◽

Laboratory Data ◽

Infectious Complications ◽

C Reactive Protein ◽

Study Objective ◽

Reactive Protein ◽

Background Data ◽

Grade Iii

Objective The study objective was to assess the predictive value of C-reactive protein (CRP) for the early detection of postoperative infectious complications (PICs) after pancreaticoduodenectomy. Summary of Background Data The incidence of PICs after pancreaticoduodenectomy still remains high and a clinically relevant problem, despite improvements in the surgical procedure. Methods We examined 110 consecutive patients who underwent pancreaticoduodenectomy for primary pancreatic cancer between 2006 and 2014. The predictive value was assessed by estimating the area under the receiver operating characteristic curve (AUC). Clinical and laboratory data, including CRP, were analyzed with univariate and multivariate logistic regression analyses to identify predictors of PICs of grade III or higher according to the Clavien-Dindo classification. Results PICs of grade III or higher occurred in 13 patients [11.8%; 95% confidence interval (CI), 6.45%–19.36%]. CRP level on postoperative day 3 (POD 3) was a good predictor of PICs (AUC, 0.815; 95% CI, 0.651–0.980), showing the highest accuracy among clinical and laboratory data. A cutoff value of 13.2 mg/dL yielded a sensitivity of 0.846 and a specificity of 0.794. On multivariate analysis, a POD 3 CRP level of 13.2 mg/dL or higher (odds ratio, 20.0; 95% CI, 4.07–97.9; P = 0.002) was a significant predictor of PICs after pancreaticoduodenectomy. Conclusions CRP elevation above 13.2 mg/dL on POD 3 is a significant predictive factor for PICs and should prompt an intense clinical search and therapeutic approach for PICs.

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Predictive impact of C-reactive protein to albumin ratio for recurrent or metastatic head and neck squamous cell carcinoma receiving nivolumab

Scientific Reports ◽

10.1038/s41598-021-82448-1 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Kenro Tanoue ◽

Shingo Tamura ◽

Hitoshi Kusaba ◽

Yudai Shinohara ◽

Mamoru Ito ◽

...

Keyword(s):

Head And Neck ◽

Characteristic Curve ◽

Area Under The Curve ◽

Progression Free Survival ◽

C Reactive Protein ◽

Optimal Cutoff ◽

Poor Overall Survival ◽

Albumin Ratio ◽

Cutoff Value ◽

Reactive Protein

AbstractAlthough the neutrophil to lymphocyte ratio (NLR) was reported to be a predictive biomarker for clinical outcomes in various types of cancer, including recurrent or metastatic head and neck cancer (R/M HNSCC) treated with nivolumab, the usefulness of the pretreatment C-reactive protein/albumin ratio (CAR) as a prognostic marker remains to be clarified. This study aimed to analyze the clinical usability of the CAR in comparison with that of the NLR. 46 R/M HNSCC patients treated with nivolumab were retrospectively analyzed. The optimal cutoff value for the CAR was calculated using receiver operating characteristic curve analysis. The optimal cutoff value for the CAR was set to 0.30. On multivariate analyses, a high CAR was significantly associated with poor overall survival (adjusted HR, 2.19; 95% CI, 1.42–3.47; p < 0.01) and progression-free survival (adjusted HR, 1.98; 95% CI, 1.38–2.80; p < 0.01). The overall response rate and disease control rate for the high CAR patients were lower than for the low CAR patients. The CAR had significantly higher area under the curve values than the NLR at 2 and 4 months. The pretreatment CAR might be an independent marker for prognosis and efficacy in R/M HNSCC patients treated with nivolumab.

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Assessment of the Relationship Between C-Reactive Protein-to-Albumin Ratio and the Presence and Severity of Isolated Coronary Artery Ectasia

Angiology ◽

10.1177/0003319720930983 ◽

2020 ◽

Vol 71 (9) ◽

pp. 840-846

Author(s):

Seçkin Dereli ◽

İdris Buğra Çerik ◽

Ahmet Kaya ◽

Osman Bektaş

Keyword(s):

Coronary Artery ◽

Characteristic Curve ◽

Obstructive Coronary Artery Disease ◽

Area Under The Curve ◽

Coronary Artery Ectasia ◽

C Reactive Protein ◽

Albumin Ratio ◽

Cholesterol Ratio ◽

Reactive Protein ◽

The Relationship

We investigated the relationship between C-reactive protein-to-albumin ratio (CAR) and coronary artery ectasia (CAE). The retrospective study population included 150 patients with isolated CAE, 150 with obstructive coronary artery disease (CAD), and 150 with a normal coronary artery angiogram (NCA). The severity of isolated CAE was determined according to the Markis classification. C-reactive protein-to-albumin ratio was significantly higher in patients with isolated CAE than in those with obstructive CAD and NCA (10.5 [5.9-30.9], 5.7 [1.8-13.2] and 3.0 [0.9-8.9], respectively). Logistic regression analysis showed that CAR (odds ratio [OR]: 3.054, 95% CI: 1.021-9.165, P = .001), platelet-to-lymphocyte ratio (PLR; OR: 1.330, 95% CI: 1.025-1.694, P = .044), and monocyte-to-high density cholesterol ratio (MHR; OR: 1.031, 95% CI: 1.009-1.054, P = .006) were independently associated with the presence of isolated CAE. Receiver operating characteristic curve analysis showed that CAR (area under the curve [AUC] ± standard error [SE] = 0.838 ± 0.016; P < .001) had a stronger diagnostic value for detecting significant CAE than PLR (AUC ± SE = 0.632 ± 0.023) and MHR (AUC ± SE = 0.726 ± 0.022). C-reactive protein-to-albumin ratio had a significantly strong correlation with the severity of isolated CAE (r = 0.536, P < .001). To the best of our knowledge, this study showed for the first time that CAR was significantly associated with CAE presence and severity.

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Severe Community-acquired Pneumonia Caused by Type 7 Human Adenovirus in Immuno competent Adults

10.21203/rs.3.rs-39416/v1 ◽

2020 ◽

Author(s):

Qin Gu ◽

Ying Xu ◽

Ran Ming Shao ◽

Ning Liu ◽

Jiang Dan Dong ◽

...

Keyword(s):

Early Stage ◽

Laboratory Data ◽

Human Adenovirus ◽

Community Acquired Pneumonia ◽

High Fever ◽

C Reactive Protein ◽

Illness Onset ◽

Reactive Protein ◽

Severe Community Acquired Pneumonia ◽

Immunocompetent Adults

Abstract Background Severe community-acquired pneumonia (SCAP) caused by human adenovirus type 7 (HAdV-7) in immunocompetent adults has been of increasing concern recently. Clinical understanding of SCAP caused by HAdV-7 in adults remains limited, though the pathogen has been adequately identified by metagenomic next-generation sequencing (mNGS). Methods We conducted a retrospective review of all patients with SCAP caused by HAdV-7 in immunocompetent adults admitted to Nanjing Drum Tower Hospital, a tertiary hospital in Nanjing, China, between July 2017 and April 2020. Clinical manifestation, laboratory findings, serial radiological characteristics, mNGS results, treatments and outcomes of these patients were collected and analyzed. Results A total of 7 SCAP patients with confirmed HAdV-7 infections were included. All patients were positive for HAdV-7 DNA fragments by mNGS for BALF and blood specimens. The median of the identified reads of two groups were 2783 and 1038, and the median coverage rates were 99.3% and 97.7%, respectively. All the patients were male and the median age was 23 years. High fever (100%), cough (57.14%) and dyspnea (100%) were the most frequent symptoms at admission. Laboratory data showed slightly decreased leucocytes but high procalcitonin and C-reactive protein levels. At early stage, with median 5 days from onset of illness, consolidation (85.71%) and patchy ground-glass opacity (GGOs) (85.71%) in unilateral lung were the most common findings in severe HAdV CAP. Within median 8 days after illness onset into progressive stage, consolidation developed and was the predominant finding in all patients, and 6 patients (85.71%) showed bilateral consolidations. In convalescent stage with median 18 days after illness onset, the parenchymal abnormalities began to absorb. Conclusions MNGS of blood or BALF could identify HAdV-7 infection accurately. Doctors should be aware of SCAP caused by HAdV-7 infection and perform mNGS as soon as possible when patients had persistent high fever, cough,decreased WBC༌high C-reactive protein and consolidation and GGO in unilateral or bilateral lungs shown by chest CT scan.

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Clinical and laboratory characteristics in outpatient diagnosis of COVID-19 in healthcare professionals in Rio de Janeiro, Brazil

Journal of Clinical Pathology ◽

10.1136/jclinpath-2020-206797 ◽

2021 ◽

pp. jclinpath-2020-206797

Author(s):

Luis Cristovao Porto ◽

Claudia H Costa ◽

Alessandra S Nunes ◽

Isabel Bouzas ◽

Tiago F Ferreira ◽

...

Keyword(s):

Reverse Transcriptase ◽

Clinical Features ◽

Rio De Janeiro ◽

Healthcare Professionals ◽

Early Stage ◽

Laboratory Data ◽

Nasopharyngeal Swab ◽

C Reactive Protein ◽

Reactive Protein ◽

Body Pain

AimsThis study aimed to identify the symptoms associated with early stage SARS-CoV-2 (COVID-19) infections in healthcare professionals (HCPs) using both clinical and laboratory data.MethodsA total of 1297 patients, admitted between 18 March and 8 April 2020, were stratified according to their risk of developing COVID-19 using their responses to a questionnaire designed to evaluate symptoms and risk conditions.ResultsAnosmia/hyposmia (p<0.0001), fever (p<0.0001), body pain (p<0.0001) and chills (p=0.001) were all independent predictors for COVID-19, with a 72% estimated probability for detecting COVID-19 in nasopharyngeal swab samples. Leucopenia, relative monocytosis, decreased eosinophil values, C reactive protein (CRP) and platelets were also shown to be significant independent predictors for COVID-19.ConclusionsThe significant clinical features for COVID-19 were identified as anosmia, fever, chills and body pain. Elevated CRP, leucocytes under 5400×109/L and relative monocytosis (>9%) were common among patients with a confirmed COVID-19 diagnosis. These variables may help, in the absence of reverse transcriptase PCR tests, to identify possible COVID-19 infections during pandemic outbreaks.SummaryFrom 19 March to 8 April 2020, 1297 patients attended the Polyclinic Piquet Carneiro for COVID-19 detection. HCP data were analysed, and significant clinical features were anosmia, fever, chills and body pain. Elevated CRP, leucopenia and monocytosis were common in COVID-19.

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Prognostic Value of Procalcitonin, C-Reactive Protein, and Lactate Levels in Emergency Evaluation of Cancer Patients with Suspected Infection

Cancers ◽

10.3390/cancers13164087 ◽

2021 ◽

Vol 13 (16) ◽

pp. 4087

Author(s):

Patrick Chaftari ◽

Aiham Qdaisat ◽

Anne-Marie Chaftari ◽

Julian Maamari ◽

Ziyi Li ◽

...

Keyword(s):

Cancer Patients ◽

Emergency Departments ◽

Characteristic Curve ◽

Laboratory Data ◽

Prediction Score ◽

Cancer Center ◽

C Reactive Protein ◽

Suspected Infection ◽

Reactive Protein ◽

Increased Risk

Cancer patients have increased risk of infections, and often present to emergency departments with infection-related problems where physicians must make decisions based on a snapshot of the patient’s condition. Although C-reactive protein, procalcitonin, and lactate are popular biomarkers of sepsis, their use in guiding emergency care of cancer patients with infections is unclear. Using these biomarkers, we created a prediction model for short-term mortality in cancer patients with suspected infection. We retrospectively analyzed all consecutive patients who visited the emergency department of MD Anderson Cancer Center between 1 April 2018 and 30 April 2019. A clinical decision model was developed using multiple logistic regression for various clinical and laboratory biomarkers; coefficients were used to generate a prediction score stratifying patients into four groups according to their 14-day mortality risk. The prediction score had an area under the receiver operating characteristic curve value of 0.88 (95% confidence interval 0.85–0.91) in predicting 14-day mortality. The prediction score also accurately predicted intensive care unit admission and 30-day mortality. Our simple new scoring system for mortality prediction, based on readily available clinical and laboratory data, including procalcitonin, C-reactive protein, and lactate, can be used in emergency departments for cancer patients with suspected infection.

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C -reactive protein and albumin ratio for the diagnosis of complicated appendicitis in children

10.21203/rs.2.18030/v2 ◽

2020 ◽

Author(s):

Wei Feng ◽

Qian-Yu Yang ◽

Xu-Feng Zhao ◽

Miao-Miao Li ◽

Hua-Lei Cui

Keyword(s):

Characteristic Curve ◽

Prognostic Score ◽

Area Under The Curve ◽

Complicated Appendicitis ◽

Symptom Duration ◽

Specific Marker ◽

C Reactive Protein ◽

Albumin Ratio ◽

Reactive Protein ◽

Independent Risk Factors

Abstract Background: No reliably specific marker for complicated appendicitis has been identified. Serum C-reactive protein (CRP) and albumin (ALB) ratio (CRP/ALB ratio) has been a new inflammation-based prognostic score which is associated with the severity of inflammation. However, its value in the diagnosis of complicated appendicitis has not been studied. The aim of this study was to evaluate the predictive value of CRP/ALB ratio for complicated appendicitis in children. Methods: A retrospective study of 232 children with acute appendicitis was conducted with assessment of age, gender, symptom duration, albumin and blood routine indexes on admission. According to intraoperative findings and postoperative pathological results, patients were divided into the simple appendicitis group (127 cases) and complicated appendicitis group (105 cases). SPSS version 17 was used to analyse the data. Results: Of the 232 patients, 118 (50.9%) were male and 114 (49.1%) were female. The CRP/ALB ratio was higher in complicated appendicitis compared with simple appendicitis (p<0.05). Logistic regression analysis showed that the higher levels of mononuclear cell count (MC), CRP, procalcitonin (PCT) and CRP/ALB ratio were independent risk factors for complicated appendicitis in children. Receiver operating characteristic curve analysis showed that the area under the curve of CRP/ALB ratio (0.946) was was bigger than MC (0.619), CRP (0.906) and PCT (0.843). CRP/ALB ratio >1.43 was found to be a significant marker in predicting complicatedappendicitis with 91.4% sensitivity and 90.6% specificity. Compared with CRP/ALB ratio =<1.43, patients with CRP/ALB ratio >1.43 had a 102.22 times higher chance of complicated appendicitis (95% CI: 41.322 - 252.874). Conclusion: Admission CRP/ALB ratio was significantly higher in children with acute complicated appendicitis. It is a novel but promising hematological marker that aids the differentiation of acute complicated and simple appendicitis.

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The use of the ratio of C-reactive protein to albumin for the diagnosis of complicated appendicitis in children

10.21203/rs.2.18030/v3 ◽

2020 ◽

Author(s):

Wei Feng ◽

Qian-Yu Yang ◽

Xu-Feng Zhao ◽

Miao-Miao Li ◽

Hua-Lei Cui

Keyword(s):

Operating Characteristic ◽

Characteristic Curve ◽

Prognostic Score ◽

Area Under The Curve ◽

Complicated Appendicitis ◽

Symptom Duration ◽

Specific Marker ◽

C Reactive Protein ◽

Reactive Protein ◽

Independent Risk Factors

Abstract Background: No reliably specific marker for complicated appendicitis has been identified. The ratio of serum C-reactive protein (CRP) to albumin (ALB) (CRP/ALB ratio) is a new inflammation-based prognostic score that is associated with the severity of inflammation. However, its value in the diagnosis of complicated appendicitis has not been studied. The aim of this study was to evaluate the predictive value of the CRP/ALB ratio for the diagnosis of complicated appendicitis in children. Methods: A retrospective study of 232 children with acute appendicitis was conducted with assessments of age, sex, symptom duration, albumin and routine blood indexes on admission. According to intraoperative findings and postoperative pathological results, patients were divided into a simple appendicitis group (127 patients) and a complicated appendicitis group (105 patients). SPSS version 17 was used to analyse the data. Results: Of the 232 patients, 118 (50.9%) were male and 114 (49.1%) were female. The CRP/ALB ratio was higher in complicated appendicitis than in simple appendicitis (p<0.05). Logistic regression analysis showed that higher levels of mononuclear cell count (MC), CRP, procalcitonin (PCT) and CRP/ALB ratio were independent risk factors for complicated appendicitis in children. Receiver operating characteristic curve analysis showed that the area under the curve of the CRP/ALB ratio (0.946) was larger than that of MC (0.619), CRP (0.906) and PCT (0.843). A CRP/ALB ratio >1.43 was found to be a significant marker in the prediction of complicated appendicitis, with 91.4% sensitivity and 90.6% specificity. Patients with a CRP/ALB ratio >1.43 had a 102.22 times higher chance of having complicated appendicitis (95% CI: 41.322 - 252.874) than those with a CRP/ALB ratio ≤1.43. Conclusion: The admission CRP/ALB ratio was significantly higher in children with acute complicated appendicitis. The CRP/ALB ratio is a novel but promising haematological marker that aids in the differentiation of acute complicated and simple appendicitis.

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The Role of C-reactive Protein in the Prediction of the Clinical Severity of Acute Diverticulitis

The American Surgeon ◽

10.1177/000313481408000423 ◽

2014 ◽

Vol 80 (4) ◽

pp. 391-395 ◽

Cited By ~ 14

Author(s):

Aristotelis Kechagias ◽

Tero Rautio ◽

Georgios Kechagias ◽

Jyrki Mäkelä

Keyword(s):

Acute Diverticulitis ◽

Characteristic Curve ◽

Area Under The Curve ◽

Clinical Severity ◽

University Hospital ◽

C Reactive Protein ◽

Mild Disease ◽

Reactive Protein ◽

Hinchey Classification ◽

Independent Risk Factors

The aim of this study is to investigate the value of C-reactive protein (CRP) and of other laboratory parameters obtained during the initial evaluation of the patient in the prediction of the clinical severity of acute diverticulitis. The records of patients treated for acute diverticulitis at the Oulu University Hospital from December 2006 to December 2008 were retrospectively reviewed. Mild disease was defined when conservative treatment was successful. Severe acute diverticulitis was considered when percutaneous drainage of an abscess and/or surgery was necessary. From the 182 patients considered for analysis, 158 (87%) had mild disease, whereas 24 (13%) had severe. CRP ( P = 0.034) and the Hinchey classification ( P = 0.006) were shown to be independent risk factors for severe acute diverticulitis in the logistic regression analysis. The receiver operating characteristic curve showed that a CRP cutoff value of 170 mg/L significantly discriminated severe from mild diverticulitis (87.5% sensitivity, 91.1% specificity, area under the curve 0.942, P < 0.00001). CRP is a useful tool in the prediction of the clinical severity of acute diverticulitis. A mild episode is very likely in patients with CRP less than 170 mg/L. Those with higher CRP values have a greater probability to undergo surgical treatment or at least a percutaneous intervention.

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