Serum C-reactive protein greater than 75 mg/dL as an early available laboratory predictor of severe COVID-19: A systematic review

IntroductionSevere COVID-19 management is still challenging. Having a laboratory factor to predict the severity of a patient's condition can be very useful in how to approach each patient. There have been studies concentrating on the correlation between serum C-reactive protein (CRP) level and COVID-19 severity but we aim to reach a threshold for CRP in disease severity determination.MethodsWe conducted a thorough search on PubMed, Web of Science and Google Scholar databases from early 2019 to October 2021, and 323 studies were assessed for eligibility in three phases. We used the Newcastle-Ottawa Scale to examine the validity of the studies. The t-test was applied for the CRP level cutoffs.ResultsEventually, 11 articles and 1615 patients were included in this systematic review. Our analysis evaluated combined mean, median, and standard deviation of severe patients' CRP to be respectively 73.37, 53.80, and 47.936. Based on the combined mean, 75 mg/dL was suggested as an initial threshold for baseline CRP in hospitalized patients for developing severe conditions.ConclusionThis study recommends that COVID-19 patients with on-admission serum CRP levels of 75 mg/dL and more are likely associated with severe conditions. Thus, anti-inflammatory agents and further following may be helpful in these patients. Having a laboratory factor to predict the severity of every COVID-19 patient can be very useful in how to approach each patient. By reviewing 11 articles and 1615 patients, baseline serum CRP of 75 mg/dL in hospitalized patients was suggested as an early predictor for developing severe conditions.image