Contribution of acute-phase reaction proteins to the diagnosis and treatment of 2019 novel coronavirus disease (COVID-19)

• Published in: Epidemiology and infection Vol. 148; p. e164
• Main Authors: Li, Lu, Chen, Changzheng
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.01.2020
• Subjects: Acute-Phase Proteins - analysis; Acute-Phase Proteins - biosynthesis; Adult; Age; Aged; Amyloid; C-reactive protein; C-Reactive Protein - analysis; C-Reactive Protein - biosynthesis; Case-Control Studies; Community-Acquired Infections - blood; Community-Acquired Infections - immunology; Complement C3 - analysis; Complement C3 - biosynthesis; Complement C4 - analysis; Complement C4 - biosynthesis; Complement component C3; Complement component C4; Coronaviridae; Coronavirus Infections - blood; Coronavirus Infections - diagnosis; Coronavirus Infections - immunology; Coronavirus Infections - therapy; Coronaviruses; COVID-19; Disease transmission; Female; Hospitals; Humans; Immune system; Immunology; Influenza; Laboratories; Male; Medical diagnosis; Middle Aged; Middle East respiratory syndrome; Original Paper; Pandemics; Patients; Pneumonia; Pneumonia - blood; Pneumonia - immunology; Pneumonia, Viral - blood; Pneumonia, Viral - diagnosis; Pneumonia, Viral - immunology; Pneumonia, Viral - therapy; Prealbumin - analysis; Prealbumin - biosynthesis; Prognosis; Proteins; Respiratory diseases; Serum Amyloid A Protein - analysis; Serum Amyloid A Protein - biosynthesis; Severe acute respiratory syndrome coronavirus 2; Severity of Illness Index; Statistical analysis; Viral diseases; Young Adult; United States > US; China; COVID-19; Acute phase reaction protein; C-reactive protein; prealbumin; complement; serum amyloid A
• DOI: 10.1017/S095026882000165X
• ISSN: 0950-2688; 1469-4409

The emergence of 2019 novel coronavirus disease (COVID-19) is currently a global concern. In this study, our goal was to explore the changing expression levels of acute-phase reaction proteins (APRPs) in the serum of COVID-19 patients and to elucidate the immunological characteristics of COVID-19. In the study design, we recruited 72 COVID-19 patients, including 22 cases of mild degree, 38 cases of moderate degree and 12 cases of severe degree. We also recruited 20 patients with community-acquired pneumonia (CAP) and 20 normal control subjects as a comparison. Fasting venous blood was taken to detect the content of complement 3 (C3), complement 4 (C4), C-reactive protein (CRP), serum amyloid A (SAA) and prealbumin (PA). When compared the COVID-19 group with the CAP and normal control groups, respectively, the mean value of CRP and SAA in the COVID-19 group (including mild, moderate and severe patients) had increased significantly (P < 0.01), whereas the mean values of C3, C4 and PA decreased (P < 0.01). For the asymptomatic or mild symptomatic patients with COVID-19, the actual aggravation of disease may be more advanced than the clinical appearances. Meanwhile, the statistical analyses indicated that the development of COVID-19 brought about a significant increase in the content of CRP and SAA (P < 0.01), and a decline in the content of C3, C4 and PA (P < 0.01). These findings suggested that the changes in the level of APRPs could be used as indicators to identify the degree and progression of COVID-19, and the significant changes might demonstrate the aggravation of disease. This study provided a new approach to improve the clinical management plan and prognosis of COVID-19.