Avaliação da proteína C reativa como preditor de gravidade da COVID-19

Abstract

Introduction: In December 2019, the severe acute respiratory syndrome caused by SARS-COV-2 had its first recorded case and was named COVID-19. The new disease quickly spread and was declared a pandemic by the World Health Organization (WHO). Many factors can influence this evolution and to assess the risk of disease progression, some laboratory markers have been used, including C-reactive protein (CRP), an easily accessible and low-cost laboratory test. Objective: The objective of this study was to evaluate CRP as a prognostic marker for COVID-19. Material and Method: Clinical and laboratory information was collected from 247 patients treated at a private hospital in São José do Rio Preto, SP, from August 2020 to February 2021. Bivariate analysis was performed to verify the association between the independent variables versus hospitalization for COVID 19, ICU admission for COVID 19, outcome and severity classification of COVID-19. Furthermore, CRP was evaluated as a predictive factor in relation to the severity classification of COVID-19 and CRP cutoff values were determined that determined greater severity of COVID-19 through the ROC curve. Results: Systemic arterial hypertension, diabetes, obesity and heart disease increased the risk of hospital admission and ICU admission. CRP was not related to any comorbidity (p>0.05), but showed a statistically significant difference between different age groups (children and adults (p=0.006) and children and elderly people (p=0.002)), and groups of different severity (mild + moderate and severe (p=0.003), mild + moderate and critical (p<0.001)). Simple linear regression showed that CRP values collected on the day the patient was tested for COVID-19 can predict the severity of the condition 𝑝 0 001 𝑅2 0 101 ))..Spearman's roh coefficient showed a correlation between entry PCR and severity (𝜑 0 346 p<0,001) and PCR and outcome (𝜑 0 322 p<0,001). Determined by the ROC curve, the PCR value of 94.5 presented a sensitivity of 51.9% and a specificity of 81.9% (p=0.001). Conclusion: It is concluded that PCR could be used as a prognostic marker in COVID-19.