C-reactive Protein as a Predictor of Severity in Chronic Obstructive Pulmonary Disease: An Experience From a Tertiary Care Hospital

Abstract

Background In this study, we aimed to determine the frequency of raised C-reactive protein (CRP) levels and their association with the severity of the disease. Methodology This descriptive cross-sectional study was conducted at the Shifa International Hospital, Islamabad, from June 2018 to December 2018 in the Department of Medicine. Patients attending the respiratory outpatient clinic in the Department of Medicine, Shifa International Hospital, Islamabad, with chronic obstructive pulmonary disease, meeting the sample selection criteria, were included in our study. A total of 104 patients were enrolled. All patients had plasma CRP levels measured, and forced expiratory volume in one second to forced vital capacity ratio was calculated to quantify the severity of the disease. We used SPSS version 26.0 (IBM Corp., Armonk, NY, USA) for data analysis. Results All patients with levels of hs-CRP greater than 3 mg/L had stage 3 or 4 chronic obstructive pulmonary disease (COPD) according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria, which accounted for 16.4% of the sample, while 81.7% of all patients suffering from COPD had levels greater than 1 mg/L. Only a small minority of patients, 1.9%, had normal high-sensitivity (hs)-CRP levels. The relationship between high levels of hs-CRP levels and advanced stages of COPD was statistically significant (p < 0.001). Conclusions The severity of COPD is directly related to the raised CRP levels, which can help in identifying these patients and managing them subsequently. It can be a useful indicator and a basis for high suspicion index and close follow-up for patients with high levels.

Elevated C-reactive protein and mortality risk among COPD patients

“…This analysis of NHANES and NDI data suggests that while having COPD increases the risk of mortality, elevated CRP levels may further increase the risk of mortality among those with COPD. Previous studies have suggested the role of inflammation in the pathogenesis, progression, and exacerbation of COPD by assessing CRP [4][5][6]15]. Some studies have also found CRP to have a high predictive value in diagnosing exacerbations of COPD [1,12].…”

“…Globally, chronic obstructive pulmonary diseases (COPD) are now among the top 3 leading causes of death with more than 3 million deaths per year and more than 50 million living with the disease [1-3]. While it is well established that COPD is a progressive disease resulting from persistent and abnormal inflammatory processes damaging the lung tissue, the search for definitive and distinct biomarkers for the disease continues [2][3][4][5]. A plethora of studies in recent times have shared genetic and biochemical data for individuals with COPD.…”

“…Among the biomarkers, inflammatory markers are probably the most highly researched and assessed. For example, multiple studies indicate that levels of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), fibrinogen, and Interleukins (e.g., 6 and 8) are elevated among patients with COPD [4][5][6][7].…”

Pentameric C-reactive protein is a better prognostic biomarker and remains elevated for longer than monomeric CRP in hospitalized patients with COVID-19

“…Although pCRP is mostly considered to be a marker of inflammation, bacterial infection or sepsis, it was established early on that pCRP levels increase during SARS-CoV-2 infection ( 17 , 18 , 20 , 23 ). Persistent elevated plasma levels of pCRP are found in chronic inflammatory diseases such as rheumatoid arthritis ( 3 ), type 2 diabetes mellitus, and Parkinson’s disease ( 29 ), and in chronic obstructive pulmonary disease ( 30 ). Whether mCRP levels are elevated in these diseases is not known, but mCRP has been implicated to play a pathogenic role in cardiovascular disease where it is detected in atherosclerotic plaques, and to cause neuroinflammation where it is found in the affected neuronal tissue ( 31 – 33 ).…”

Correlations of blood C-reactive protein level with other clinical indicators in patients with chronic obstructive pulmonary disease

“…С-реактивний білок -це сполука, вміст якої збільшується в плазмі крові при різних запальних станах. Результати досліджень вказують на те, що навіть пацієнти зі стабільним перебігом ХОЗЛ мають підвищені рівні С-реактивного білка у сироватці крові, що корелює з тяжкістю хвороби, а також може корелювати з виникненням ускладнень [2]. Саме тому перспективним є аналіз кореляційних зв´язків рівня С-реактивного білка у крові із іншими клінічними, лабораторними, інструментальними показниками у пацієнтів з ХОЗЛ.…”