A simple non-invasive C reactive protein-based score can predict outcome in patients with COVID-19

Abstract

Background. We evaluated the role of CRP and other laboratory parameters in predicting the worsening of clinical conditions during hospitalization, ICU admission and fatal outcome among patients with COVID-19. Methods. We enrolled consecutive adult inpatients with SARS-CoV-2 infection and respiratory symptoms treated in three different COVID centres. We looked for laboratory parameters collected within 48 hours from hospital admission as predictors of clinical condition. Results. Three-hundred ninety patients were included in the study. At the correlation and regression analysis, age, baseline CRP and LDH were associated with a P/F ratio<200 during hospitalization. At the multivariate analysis, male gender and CRP > 60 mg/l at admission showed to be independently associated with ICU admission. Lymphocytes<1000 cell/μL at admission were associated with worst P/F ratio. The only laboratory predictor of fatal outcome was CRP>60 mg/l at admission. Based on these results, we devised an 11-points numeric ordinary score based on age, sex, CRP and LDH at admission (ASCL score). Patients with ASCL score of 0 or 2 showed to be protected against a P/F ratio<200, while patients with ASCL score of 6, 7 and 8 showed to be at risk for P/F ratio<200. Patients with ASCL score≥7 had a significant increase to die during the hospitalization. Conclusions. Patients with CRP>60 mg/l or LDH>300 IU/l at hospital admission, as well as patients with an ASCL score>6 at hospital admission, should be prioritized for careful respiratory function monitoring and early treatment to prevent a progression of the disease.