• Xiaomin Luo, Wei Zhou, Xiaojie Yan, Tangxi Guo, Benchao Wang, Hongxia Xia, Lu Ye, Jun Xiong, Zongping Jiang, Yu Liu, Bicheng Zhang, and Weize Yang.
• Department of Emergency, Eastern Campus, Renmin Hospital of Wuhan University, Wuhan, China.
• Clin. Infect. Dis. 2020 Nov 19; 71 (16): 2174-2179.

BackgroundAn elevated serum C-reactive protein (CRP) level was observed in most patients with coronavirus disease 2019 (COVID-19).MethodsData for COVID-19 patients with clinical outcome in a designated hospital in Wuhan, China, were retrospectively collected and analyzed from 30 January 2020 to 20 February 2020. The prognostic value of admission CRP was evaluated in patients with COVID-19.ResultsOf 298 patients enrolled, 84 died and 214 recovered. Most nonsurvivors were male, older, or with chronic diseases. Compared with survivors, nonsurvivors showed significantly elevated white blood cell and neutrophil counts, neutrophil to lymphocyte ratio (NLR), systemic immune inflammation index (defined by platelet count multiplied by NLR), CRP, procalcitonin, and D-dimer and showed decreased red blood cell, lymphocyte, and platelet counts. Age, neutrophil count, platelet count, and CRP were identified as independent predictors of adverse outcome. The area under the receiver operating characteristic (ROC) curve (AUC) of CRP (0.896) was significantly higher than that of age (0.833), neutrophil count (0.820), and platelet count (0.678) in outcome prediction (all P < .05). With a cutoff value of 41.4, CRP exhibited sensitivity of 90.5%, specificity of 77.6%, positive predictive value of 61.3%, and negative predictive value of 95.4%. CRP was also an independent discriminator of severe/critical illness on admission with an AUC (0.783) comparable to age (0.828) and neutrophil count (0.729) (both P > .05).ConclusionsIn patients with COVID-19, admission CRP correlated with disease severity and tended to be a good predictor of adverse outcome.© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

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