Evidence map›Paper›PMID 33174788›Full record

ArticleScandinavian journal of primary health care2020

Is C-reactive protein associated with influenza A or B in primary care patients with influenza-like illness? A cross-sectional study.

Karin Rystedt, Nicolay Jonassen Harbin, Morten Lindbaek, Ruta Radzeviciene, Ronny Gunnarsson, Robert Eggertsen, Christopher C Butler, Alike W van der Velden, Theo J Verheij, Pär-Daniel Sundvall

Open access · goldAbstract read
In one paragraph

Article in Scandinavian journal of primary health care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.6field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 8 citations in OpenAlex.

  1. Trial
  2. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 6 institutions in 4 countries.

Karin RystedtRegion Västra Götaland, Research and Development Primary Health Care, Research and Development Centre Skaraborg, Skövde, Sweden.
Nicolay Jonassen HarbinDepartment of General Practice, Antibiotic Center for Primary Care, Institute of Health and Society, University of Oslo, Oslo, Norway.
Morten LindbaekDepartment of General Practice, Antibiotic Center for Primary Care, Institute of Health and Society, University of Oslo, Oslo, Norway.
Ruta RadzevicieneMano Seimos gydytojas, Klaipeda, Lithuania.
Ronny GunnarssonPrimary Health Care, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Robert EggertsenPrimary Health Care, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Christopher C ButlerDepartment of Primary Care Health Services, University of Oxford, Radcliffe Observatory Quarter, Oxford, UK.
Alike W van der VeldenJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
Theo J VerheijJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
Pär-Daniel SundvallPrimary Health Care, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
University Medical Center Utrecht · NLUniversity of Gothenburg · SEUniversity of Oslo · NORegion Västra Götaland · SESödra Älvsborg Hospital · SEUniversity of Oxford · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveIdentifying influenza A or B as cause of influenza-like illness (ILI) is a challenge due to non-specific symptoms. An accurate, cheap and easy to use biomarker might enhance targeting influenza-specific management in primary care. The aim of this study was to investigate if C-reactive protein (CRP) is associated with influenza A or B, confirmed with PCR testing, in patients presenting with ILI.

designCross-sectional study.

settingPrimary care in Lithuania, Norway and Sweden. SUBJECTS: A total of 277 patients at least 1 year of age consulting primary care with ILI during seasonal influenza epidemics.

main outcome measuresCapillary blood CRP analysed as a point-of-care test and detection of influenza A or B on nasopharyngeal swabs in adults, and nasal and pharyngeal swabs in children using PCR.

resultsThe prevalence of positive tests for influenza A among patients was 44% (121/277) and the prevalence of influenza B was 21% (58/277). Patients with influenza A infection could not be identified based on CRP concentration. However, increasing CRP concentration in steps of 10 mg/L was associated with a significantly lower risk for influenza B with an adjusted odds ratio of 0.42 (0.25-0.70;

conclusionsThere was no association between CRP and influenza A. Increased concentration of CRP was associated with a lower risk for having influenza B, a finding that lacks clinical usefulness. Hence, CRP testing should be avoided in ILI, unless bacterial pneumonia is suspected. Key points Identifying influenza A or B as cause of influenza-like illness (ILI) is a challenge due to non-specific symptoms. There was no association between concentration of CRP and influenza A. Increased concentration of CRP was associated with a lower risk for having influenza B, a finding that lacks clinical usefulness. A consequence is that CRP testing should be avoided in ILI, unless bacterial pneumonia or similar is suspected.

Indexed as

C-Reactive ProteinInfluenza, HumanAdultChildCross-Sectional StudiesFemaleHumansNorwayPrimary Health CareSwedenC-Reactive ProteinC-reactive proteininfluenza in humanspoint-of-care testingprimary health carerespiratory tract infections

Identifiers

PMID33174788
PMCPMC7782939
OpenAlexW3098006436

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.