DATA ANALYTICS ON TREND OF C-REACTIVE PROTEIN (CRP) LEVEL AND ITS CORRELATION WITH OTHER CLINICAL PARAMETERS IN DESCRIBING DISEASE PROGRESSION OF MILD COVID- 19 PATIENTS

Abstract

Introduction: CRP is well known inflammatory marker and has been used as one of the haematological parameters to monitor the disease progression of COVID-19 patients. Several publications have reported the correlation between a high CRP level and the severity of COVID-19 infection as well as the possibility of using the CRP level as a predictive marker of a severe disease or an adverse outcome. However, a time-series analysis of the trend of CRP level in relation to the day of illness has not been done. Therefore, this study aims to assess the trend of CRP level in relation to the days of illness among patients with mild COVID-19 infection and to find its correlation with other clinical parameters in describing the progression of the disease. Apart from that, this study also aims to explore the possibility of CRP level being utilized as an indicator to determine if the patient is on the road to recovery. In view that CRP level is also known to increase with age and various chronic diseases, this study aims to only focus on a specific group of population who may be presumed to be healthy individuals to minimize the effect of other potential confounders. Methodology: Random sampling of 100 patients was done on patients who were admitted to the MAEPS Integrated Low Risk COVID-19 Treatment and Quarantine Centre 2.0, Serdang in August 2021. The medical records of each patient were accessed to retrieve the laboratory investigation results which was mapped by days of illness. Other clinical parameters information was also extracted based on a standard data collection form. A descriptive statistical analysis of the data was carried out to identify the trend of CRP levels in patients with mild COVID-19. Results: Most patients were admitted to PKRC MAEPS 2.0 within 4 days of testing positive for COVID-19. Out of these, 37 were fully vaccinated, 28 partially vaccinated and 35 unvaccinated. A different trend of CRP level emerged for these three different groups of patients, indicating an effect of vaccination on their inflammatory response. However, due to the large variation in the CRP levels and limited sampling size, a clear trend of the CRP level in relation to the day of illness to describe the disease progression was not established. On the other hand, high CRP level was associated with cough, anosmia and ageusia while fever was more commonly reported by patients with a lower value of CRP. Conclusion: CRP level is elevated in COVID-19 patients, but its actual value is not predictive of the outcome of patients with mild infection. This value is also affected by the vaccination status of the patient and may not be a useful for an infectious disease monitoring when there is an active vaccination programme taking place. Keywords: COVID-19, C-reactive protein, CRP, trend, data analytic