Correlation between C-reactive Protein (CRP) Level and Clinicoradiological Profile in COVID-19 Patients Admitted in a Tertiary Care Hospital in Eastern India

Background : Coronavirus disease 2019, first reported in December 2019 mainly presented with the symptoms of Cough, Fever, Shortness of breath, Myalgia, Weakness and anosmia. C-reactive Protein (CRP) is an acute-phase reactant protein which is synthesized by the liver in response to raised levels of interleukin-6 (IL-6) which is a biomarker of inflammation. Methods : This was a prospective observational study, done on 110 COVID-19 patients after applying inclusion and exclusion criteria. Detailed history, vaccination status, presence of comorbidities and thorough clinical examination was performed. Serum CRP levels was assessed and Computed Tomographic scan (CT scan) of Thorax was done. CORADS scoring and CT severity grading as per CT scan was done. All the above parameters were recorded in the preformed proforma and data was entered in excel spreadsheet and was analysed using SPSS v26 software. Results : Majority were males (56.3%) and majority were from 61-80 years of age. Majority (57.3%) patients were non-smokers. Hypertension was the most common associated comorbidity (86.4%)(r=0.743, p=0.000). There is a strong positive correlation between CRP levels and CTSS in COVID 19 patients and a strong negative correlation between the CRP levels and outcome of COVID-19 patients (r= -0.449, p=0.000). Conclusion : Elevated serum CRP value is associated with disease progression and poorer outcome.

Significance of Neutrophil Gelatinase-Associated Lipocalin Level as an Acute-Phase Reactant in Patients with Systemic Inflammatory Response Syndrome

BACKGROUND: We investigated the significance of plasma neutrophil gelatinase-associated lipocalin (pNGAL) level as an acute-phase reactant and an index for an increase in serum creatinine (sCr) level in patients with inflammatory diseases. METHODS: A total of 63 patients with systemic inflammatory response syndrome (SIRS) and 149 without SIRS were evaluated, and pNGAL level was determined using a fluorescence immunoassay. sCr levels were measured daily during three days, and the difference between the initial and follow-up sCr levels was defined as a delta sCr value. Serum albumin/sCr ratio (sACR) was calculated. High-sensitivity C-reactive protein (hsCRP) level was determined using a latex turbidometric method. RESULTS: The median pNGAL level in the SIRS group (154 ng/mL) was significantly higher than that in the non-SIRS (86 ng/mL) and control (62 ng/mL) groups (P<0.001, respectively). The area under the ROC curve (AUC) of pNGAL for diagnosing SIRS was 0.725 (95% CI, 0.664-0.781), which was not significantly different from that of hsCRP (0.749; 95% CI, 0.685-0.809; P=0.375). Multivariate regression analyses revealed that log-pNGAL was significantly associated with hsCRP (beta=0.546, P<0.001) and sACR (beta=0.351, P<0.001). The AUC of pNGAL for the positive delta sCr in 48-72 hr was 0.649 (95% CI, 0.542-0.746, P=0.023) in the SIRS group. CONCLUSIONS: pNGAL is comparable to hsCRP as an inflammation-related parameter, and its measurement may provide additional information for a potential increase in sCr during 48-72 hr in patients with SIRS.

Role of serum HsCRP as prognostic markers in septicemia in elderly population.

Background: Presence of elevated serum HsCRP is strongly associated with morbidity and mortality in diverse populations with sepsis and is a potentially useful biomarker to risk stratify patients with severe sepsis. Aims & Objective: We aimed to study whether the serum HsCRP level at presentation in elderly patients with sepsis correlate with stage of sepsis and ultimate outcome. Material and Methods: In a single centre prospective, observational study conducted in geriatric ward of tertiary care centre, 200 elderly patients (age>60 yrs) with sepsis were included. The primary outcome was 14 days in hospital mortality. Risk factor variable was venous serum HsCRP (mg/l) at presentation. Results: Mortality at 14 days in elderly patients with sepsis was 20%. Mean serum HsCRP in survivor group was 33.42 ± 21.56 while 57.28 ± 25.31 in mortality group (p value <0.001). The mean serum HsCRP level in survivor and non survivors was 32.49 ± 21.45 and 48.05 ± 16.40 in sepsis, 33.61 ± 25.45 and 67.71 ± 21.49 in severe sepsis, 46.62 ± 10.55 and 73.82 ± 32.87 in MODS while 49.0 ± 26.72 and 101.5 ± 9.19 in septic shock group. Conclusion: We conclude that initial high serum HsCRP level was associated with increased mortality independent of etiology of sepsis, it also correlate well with severity of sepsis and serum HsCRP level were high in those with septic shock.

Syndrome of malnutrition-inflammation complex in chronic alcoholics.

Several studies have reported elevated serum ferritin levels in patients of chronic alcohol abuse. We hypothesized that serum ferritin may be acting as a marker of acute phase reactant, reflecting the inflammatory status of patients of chronic alcohol abuse, rather than as a marker of iron overload . Hence we correlated serum ferritin levels with interleukin 6 (IL-6), interleukin 1 (IL-1) and tumor necrosis factor alpha (TNF -α ) which are markers of inflammation. Serum ferritin and IL-6 levels were significantly elevated at the time of admission. The elevation of IL-6 correlated well with the increase in ferritin levels (r=0.78, p<0.01). Serum iron levels were not significantly different before and after abstinence from alcohol. We also speculated that the inflammatory status was associated with the malnutrition that is observed in alcohol abuse. Therefore we studied serum total protein, albumin, prealbumin and transferrin levels as markers of nutrition in patients of chronic alcohol abuse. Serum levels of all these nutritional parameters increased significantly after 8 weeks of abstinence from alcohol and were accompanied by reduced levels of ferritin and IL-6. Hence it is possible that a malnutrition inflammation complex like syndrome exists in patients of alcohol abuse.

Changes of Plasma Lipoprotein(a) Levels as a Acute Phase Reactantfrom Antepartum to Postpartum Period / 대한산부인과학회잡지

Lipoprotein(a)[Lp(a)] represents a class of lipoprotein particles defined by the presence of apolipoprotein(a), a unique glycoprotein linked by a disulfide bond to apolipoprotein B-100 to form a single macromolecule. It was known that Lp(a) levels were associated with risk factor for cardiovascular disease and were fluctuated during pregnancy and postpartum. In the present study, plasma Lp(a) levels were estimated in two groups of women comprising 48 normal spontaneous vaginal delivery group and 52 Cesarean section delivery group. The changes of plasma Lp(a) concentrations were serially estimated before delivery, postpartum 1 weeks and postpartum 6 weeks. The result can be summarized as follows.1. Mean ploasma Lp(a) levels were changed from 43.9 +/- 28.4 mg/dl at delivery to 68.5 +/- 35.5 mg/dl at postpartum 1 weeks 73.1 +/- 35.7 mg/dl versus 63.7 +/- 35.1 mg/dl. And after postpartum 6 weeks, mean plasma Lp(a) levels were returned to near initial levels 48.4 +/- 21.1 mg/dl versus 42.2 +/- 16.7 mg/dl.3. Lp(a) levels were significantly rised postpartum 1 weeks compared with before delivery(p < 0.05) and after postpatum 6 weeks(p < 0.05). In conclusion, serum Lp(a) levels were increased postpartum 1 weeks with significant value, and returned to initial levels after postpartum 6 weeks. Our findings suggests that Lp(a) has the characteristics of an acute phase reactant rather modulated by endogenous hormone.

Clinical Usefulness Of Performance Scale In The Assessment Clinical Activity Of Rheumatoid Arthritis / 대한류마티스학회지

OBJECTIVE: Inflammation has long been recongnized as notoriously difficult to measure both in clinical practice and in the laboratory methods. The methods used to clinical assess rheumatoid arthritis should share the following four parameters : validity, sensitivity, reliability and simplicity. Our purposes were evaluate mehtods of accurately reflecting disease activity in rheumatoid arthritis. METHODS: We examed 32 cases(male : 4, famale:28 and mean age : 51 years) of rheumatoid arthritis. The clinical assessment included the following : (1) performance scales including grip strength, button test, and 7.5 M walking time. (2) activity of daily living(ADL) questionnaires. (3) articular indices including Ritchie, ARA and restricted joint index. (4) Laboratory assessment, Made on at the same time with the clinical assessment, included fellwing: erythrocyte sedimentation rate and CRP. RESULTS: 1. Performance scale scores were well correlated with articular indeces but ARA index showed the most frequent and strongest correlations with performance scale. 2. Performance scale score were well correlated with ADL score but ADL pain score showed the most frequent and the strongest correlation. 3. Performance scale score were more strongly correlated with CRP than with ESR. CONCLUSION: The performance scale score appear to provide useful data for quantitatire assessment of inflammatory activity of joints in the routine care of RA.