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Article Type

Original Study

Abstract

Introduction Robust data are available for C-reactive protein (CRP) in bacterial infection, and it can be used in this coronavirus disease 2019 (COVID-19) pneumonia pandemic for initial assessment before planning of treatment in indoor settings in comparison with other inflammatory markers and computed tomography (CT) severity. Materials and methods A prospective, observational, follow up study was conducted that included 1000 COVID 19 cases confirmed with RT PCR. All cases were assessed with lung involvement documented and categorized based on high resolution computed tomography (HRCT) thorax, oxygen saturation, and inflammatory markers such as CRP at the entry point and follow up. Age, sex, comorbidities, use of BIPAP/NIV (Bi-level positive airway pressure/Non-invasive ventilation), and outcomes such as with or without lung fibrosis as per HRCT severity were key observations. Statistical analysis was done using χ2 test. Results Age (<50 and >50 years) and sex (male versus female) had a significant association with CRP in predicting severity (P < 0.00001 and P < 0.010, respectively). CT severity score at the entry point with CRP level had a significant correlation (P < 0.00001). CRP level had a significant association with duration of illness (P < 0.00001). Comorbidities had a significant association with CRP level (P < 0.00001). CRP level had a significant association with oxygen saturation (P < 0.00001). BIPAP/NIV requirement during hospitalization had a significant association with CRP level (P < 0.00001). Timing of BIPAP/NIV requirement had a significant association with CRP level. (P < 0.00001). Follow-up CRP titer during hospitalization as compared with the entry point normal and abnormal CRP levels showed a significant association in post-COVID lung fibrosis (P < 0.00001). Conclusion CRP is an easily available and universally acceptable inflammatory marker and documented to play a very crucial role in predicting timings of interventions and post-COVID lung fibrosis.

Keywords

COVID-19 pneumonia, CRP, inflammatory marker, oxygen saturation

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