The current pandemic caused by SARS-CoV-2 virus infection is known as Covid-19 (coronavirus disease 2019). This disease can be asymptomatic or can affect multiple organ systems. Damage induced by the virus is related to dysfunctional activity of the immune system, but the activity of molecules such as C-reactive protein (CRP) as a factor capable of inducing an inflammatory status that may be involved in the severe evolution of the disease, has not been extensively evaluated. A systematic review was performed using the NCBI-PubMed database to find articles related to Covid-19 immunity, inflammatory response, and CRP published from December 2019 to December 2020. High levels of CRP were found in patients with severe evolution of Covid-19 in which several organ systems were affected and in patients who died. CRP activates complement, induces the production of pro-inflammatory cytokines and induces apoptosis which, together with the inflammatory status during the disease, can lead to a severe outcome. Several drugs can decrease the level or block the effect of CRP and might be useful in the treatment of Covid-19.From this review it is reasonable to conclude that CRP is a factor that can contribute to severe evolution of Covid-19 and that the use of drugs able to lower CRP levels or block its activity should be evaluated in randomized controlled clinical trials.
K E Y W O R D SC-reactive protein, COVID-19, SARS-CoV-2, severe evolution
| INTRODUCTIONSARS-CoV-2 starts its pathogenetic process through reninangiotensin system (RAS) activation, binding to the angiotensin II converting enzyme (ACE2) and originating a series of proinflammatory events that can induce a cytokine storm. 1,2 The C-reactive protein (CRP) is a molecule produced by the interaction of SARS-CoV-2 with ACE2, 3-5 which is not only an indicator of acute phase of inflammation but also has been related to prognosis and severity of Covid-19. [5][6][7] Therefore, CRP can be an important factor in the cellular damage during Covid-19. This review aims to describe the different mechanisms by which SARS-CoV-2 can induce cell