Investigation of the Relationship between C-Reactive Protein and Lymphocyte Counts in Mortality and Prognosis of Patients with Covid 19
Authors
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Amir Khanmirzaei
- Student Research Committee, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran.
https://orcid.org/0000-0003-4949-0306
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Maryam Khodayar
- Clinical Research Development Unit, Imam Hossein Hospital, Shahroud University of Medical Sciences, Shahroud, Iran.
https://orcid.org/0000-0002-6144-3775
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Mostafa Enayatrad
- Clinical Research Development Unit, Bahar Hospital, Shahroud University of Medical Sciences, Shahroud, Iran.
https://orcid.org/0000-0003-3465-3715
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Amir Noyani
- Clinical Research Development Unit, Imam Hossein Hospital, Shahroud University of Medical Sciences, Shahroud, Iran.- Emergency Medicine Dept., Treetop Hospital, Male, Maldive.
https://orcid.org/0000-0002-3614-1150
DOI:
https://doi.org/10.22100/jkh.v17i3.2800Abstract
Introduction: Testing C-reactive protein with a decrease in blood lymphocytes can help in the rapid diagnosis of Covid -19 disease. Therefore, this study was performed to investigate the relationship between C-reactive protein levels and lymphopenia on mortality from Covid 19 disease.
Methods: The present study is a cross-sectional analytical study that was performed on 179 patients with Covid-19 referred to Imam Hossein Hospital in Shahroud. Subjects with positive PCR test, presence of C-reactive protein and lymphocytes in the experiments, outpatient referral or hospitalization in normal wards, ICU, and CCU of the hospital were included in the study. Chi-square and independent t-tests were used for statistical analysis using SPSS software version 23. The significance level was considered 0.05.
Results: 179 patients were included in the study, 51.4% of whom were male. The mortality rate in the lymphopenia group was 15.9%, which was higher than the group with normal lymphocytes, and the mean age of those who died of the disease was significantly higher than those who improved (P=0.01). The results also showed that the mean age in people with high CRP is higher (P=0.01).
Conclusion: According to the present study and the higher mortality rate in patients with lymphopenia, lymphopenia can be suggested as an indicator of the prognosis of patients, and also CRP can be considered a factor for the risk of mortality in patients.
References
Gong Feng, Kenneth I Zheng, Qin-Qin Yan, Rafael S Rios, Giovanni Targher, Christopher D Byrne, et a. J Clin Transl Hepatol 2020;8:18-24. doi: 10.14218/JCTH.2020.00018
Wiersinga WJ, Rhodes A, Cheng AC, Peacock SJ, Prescott HC. Pathophysiology, Transmission, Diagnosis, and Treatment of Coronavirus Disease 2019 (COVID-19): A Review. JAMA 2020;324:782-93. doi: 10.1001/jama.2020.12839
Wu F, Zhao S, Yu B, Chen Y-M, Wang W, Song Z-G, et al. A new coronavirus associated with human respiratory disease in China. Nature 2020;579:265-9.
Shannon L Emery, Dean D Erdman, Michael D Bowen, Bruce R Newton, Jonas M Winchell, Richard F Meyer, et al. Real-time reverse transcription–polymerase chain reaction assay for SARS-associated coronavirus. Emerg Infect Dis 2004;10:311-6. doi: 10.3201/eid1002.030759
C M Chu, V C C Cheng, I F N Hung, M M L Wong, K H Chan, K S Chan, et al. Role of lopinavir/ritonavir in the treatment of SARS: initial virological and clinical findings. Thorax 2004;59:252-6. doi: 10.1136/thorax.2003.012658
Dessmon Y H Tai. Pharmacologic treatment of SARS: current knowledge and recommendations. Ann Acad Med Singap 2007;36:438-43. doi: 10.1101/2020.01.27.921627
Mark B Pepys, Gideon M Hirschfield. C-reactive protein: a critical update. J Clin Invest 2003;111:1805-12. doi: 10.1172/JCI18921
Pepys MB, Baltz ML. Acute phase proteins with special reference to C-reactive protein and related proteins (pentaxins) and serum amyloid A protein. Advances in Immunology 1983;34:141-212. doi: 10.1016/s0065-2776(08)60379-x
Peng Zhou, Xing-Lou Yang, Xian-Guang Wang, Ben Hu, Lei Zhang, Wei Zhang, et al. Addendum: A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature 2020, 588.7836:E6-E6. doi: 10.1038/s41586-020-2951-z
Qiurong Ruan, Kun Yang, Wenxia Wang, Lingyu Jiang & Jianxin Song. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Medicine 2020;46:846-8. doi: 10.1007/s00134-020-05991-x
Xiaobo Yang, Yuan Yu, Jiqian Xu, Prof Huaqing Shu, Prof Jia'an Xia, Prof Hong Liu, et al.. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. The Lancet Respiratory Medicine 2020;8:475-81. doi: 10.1016/S2213-2600(20)30079-5
Wei Chen, Kenneth I Zheng, Saiduo Liu, Zhihan Yan, Chongyong Xu, Zengpei Qiao. Plasma CRP level is positively associated with the severity of COVID-19. Annals of Clinical Microbiology and Antimicrobials 2020;18:1-7.doi: 10.1186/s12941-020-00362-2
Diamond S Michael, Theodore C Pierson. Molecular insight into dengue virus pathogenesis and its implications for disease control. Cell 2015;162:488-92. doi: 10.1016/j.cell.2015.07.005
Sophie Y, Wills B. Predicting outcome from dengue. BMC Medicine 2014;12:1-10.. doi: 10.1186/s12916-014-0147-9
Hu Y, Zhuoran S, Jun W, Aiguo T, Min H, Zhongyuan X. Laboratory data analysis of novel coronavirus (COVID-19) screening in 2510 patients. Clin Chim Acta 2020;507:94-7. doi: 10.1016/j.cca.2020.04.018
Yang M, Chen X, XU Y. A retrospective study of the C-reactive protein to lymphocyte ratio and disease severity in 108 patients with early COVID-19 pneumonia from January to March 2020 in Wuhan, China. Med Sci Monit 2020;26: e926393-1-8. doi: 10.12659/MSM.926393
Colenda Christopher C, William B, Burton V. Dan G. COVID-19: financial stress test for academic medical centers. Academic Medicine 2020;95:1143-5. doi: 10.1097/ACM.0000000000003418
RIPP, Jonathan; PECCORALO, Lauren; CHARNEY, Dennis. Attending to the emotional well-being of the health care workforce in a New York City health system during the COVID-19 pandemic. Acad Med 2020;95:1136-9. doi: 10.1097/ACM.0000000000003414
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