ABSTRACT
BACKGROUND: COVID-19 clinical course has been quite unpredictable and efforts have been made to identify reliable markers that will help in early disease progression, prognosis and severity detection. Objective: This study thus aimed to provide evidence that will guide clinical management by reviewing studies that assessed CRP concentration and COVID-19 severity/outcome. METHODS: Three electronic databases, PubMed/Medline, Google Scholar, and JSTOR were searched to identify studies available online as at 1st September 2020 which assessed COVID-19 clinical outcome and CRP concentration. The search strategy involved words combination like "C-reactive protein" OR "inflammatory markers" OR "acute phase reactants" and "coronavirus 2019" OR ''COVID-19" OR "2019-nCoV" OR "SARS-CoV-2". RESULTS: Sixty-one articles were systematically reviewed out of 812 studies identified after duplicates were removed. The 61 studies comprised 13,891 COVID-19 patients made of 7,840 (56.4%) males and 6,051 (43.6%) females. All the papers revised were observational studies except one case-control and they cut across fifteen countries. The result of the review demonstrated that the severe cases had higher levels of C - reactive protein when compared to the mild cases in all the studies (100%). The increase in C-reactive protein was statistically significant in 78.7% of the cases. CONCLUSION: High levels of CRP are associated with COVID-19 severity. Highlights: Severe cases of COVID-19 is characterized with higher CRP levels. COVID-19 cases should be screened regularly for CRP to monitor severity.
Contexte: L'évolution clinique du COVID-19 a été assez imprévisible et des efforts ont été faits pour identifier des marqueurs fiables qui aideront à la progression précoce de la maladie, au pronostic et à la détection de la gravité. Objectif : Cette étude visait donc à fournir des preuves qui guideront la gestion clinique en passant en revue les études qui ont évalué la concentration de CRP et la gravité/l'issue du COVID-19. Méthodes: Trois bases de données électroniques, PubMed/Medline, Google Scholar et JSTOR, ont été consultées pour identifier les études disponibles en ligne au 1er septembre 2020 qui évaluaient le résultat clinique du COVID-19 et la concentration de CRP. La stratégie de recherche comportait des combinaisons de mots comme "protéine Créactive" OU "marqueurs inflammatoires" OU "réactifs de phase aiguë" et "coronavirus 2019" OU "COVID-19" OU "2019-nCoV" OU "SARS-CoV-2". Résultats: Soixante et un articles ont été systématiquement examinés sur les 812 études identifiées après suppression des doublons. Les 61 études comprenaient 13 891 patients atteints de COVID-19, dont 7 840 (56,4 %) hommes et 6 051 (43,6 %) femmes. Tous les articles examinés étaient des études d'observation, à l'exception d'un cas-témoin, et ils couvraient quinze pays. Le résultat de l'examen a démontré que les cas graves avaient des niveaux plus élevés de protéine C-réactive par rapport aux cas légers dans toutes les études (100%). L'augmentation de la protéine C-réactive était statistiquement significative dans 78,7% des cas. Conclusion: Des niveaux élevés de CRP sont associés à la sévérité du COVID-19. Mots clés: Protéine C-réactive, COVID-19, SRAS-COV-2 et Coronavirus. Points forts: Les cas graves de COVID-19 sont caractérisés par des niveaux de CRP plus élevés. · Les cas de COVID-19 doivent faire l'objet d'un dépistage régulier de la CRP afin de surveiller la gravité de la maladie.
Subject(s)
C-Reactive Protein , COVID-19 , Biomarkers , C-Reactive Protein/analysis , Case-Control Studies , Female , Humans , Male , Receptors, Immunologic , SARS-CoV-2ABSTRACT
BACKGROUND: Necrotizing soft tissue infection of the ear following ear piercing is a very rare condition. It is easily misdiagnosed leading to reconstructive morbidities and mortality in neonates. High clinical suspicion is important for early diagnosis. Our knowledge, this is the first case reported in the literature in this unique initial presentation. We hope to heighten the awareness of necrotizing soft tissue infection of the ear following ear piercing to ensure early aggressive intervention. CASE PRESENTATION: We report a set of 19-day-old female twin neonates who developed bilateral ear sores following ear piercing in a primary healthcentre without adherence to surgical asepsis. Examination findings showed features consistent with necrotizing soft tissue infections of the ears. They were successfully managed with antibiotics and wound care. CONCLUSION: Necrotizing soft tissue infections is a very rare complication of neonatal ear piercing. It may occur following suboptimal aseptic procedure and a high index of suspicion is necessary to make this diagnosis to ensure early intervention and to forestall the potential reconstructive morbidities and mortality associated with late recognition. Adherence to basic aseptic surgical principles is the key to prevention of necrotizing soft tissue infections.
