C-reactive protein isoforms as prognostic markers of COVID-19 severity
Molins, Blanca (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Figueras-Roca, Marc (Hospital Clínic i Provincial de Barcelona)
Valero, Oliver (Universitat Autònoma de Barcelona. Departament de Matemàtiques)
Llorenç, Víctor (Hospital Clínic i Provincial de Barcelona)
Romero-Vázquez, Sara (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Sibila, Oriol (Hospital Clínic i Provincial de Barcelona)
Adan Civera, Alfredo (Hospital Clínic i Provincial de Barcelona)
Garcia-Vidal, Carolina (Hospital Clínic i Provincial de Barcelona)
Soriano Viladomiu, Alex (Hospital Clínic i Provincial de Barcelona)

Data:	2023
Resum:	C-reactive protein (CRP), an active regulator of the innate immune system, has been related to COVID-19 severity. CRP is a dynamic protein undergoing conformational changes upon activation in inflammatory microenvironments between pentameric and monomeric isoforms. Although pentameric CRP is the circulating isoform routinely tested for clinical purposes, monomeric CRP shows more proinflammatory properties. Therefore, we aimed to determine the potential of monomeric CRP in serum as a biomarker of disease severity in COVID-19 patients (admission to intensive care unit [ICU] and/or in-hospital mortality). We retrospectively determined clinical and biological features as well as pentameric and monomeric CRP levels in a cohort of 97 COVID-19 patients within 72h of hospital admission. Patients with severe disease had higher levels of both pentameric and monomeric CRP. However, multivariate analysis showed increased mCRP but not pCRP to be independently associated to disease severity. Notably, mCRP levels higher than 4000 ng/mL (OR: 4. 551, 95% CI: 1. 329-15. 58), together with number of co-morbidities, low lymphocyte count, and procalcitonin levels were independent predictors of disease severity in the multivariate model. Our results show the potential of mCRP levels as a marker of clinical severity in COVID-19 disease.
Ajuts:	Instituto de Salud Carlos III PI19/00265
Nota:	Altres ajuts: Fundació Glòria Soler; l'Hospital Clínic de Barcelona-Fundació Clínic per a la Recerca Biomèdica
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	C-reactive protein ; COVID-19 ; Isoforms ; Inflammation ; Prognosis
Publicat a:	Frontiers in immunology, Vol. 13 (January 2023) , art. 1105343, ISSN 1664-3224

DOI: 10.3389/fimmu.2022.1105343
PMID: 36741367

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