Evidence map›Paper›PMID 33448289›Full record

ArticleEuropean heart journal2021

C-reactive protein and clinical outcomes in patients with COVID-19.

Nathaniel R Smilowitz, Dennis Kunichoff, Michael Garshick, Binita Shah, Michael Pillinger, Judith S Hochman, Jeffrey S Berger

Registry-linked trialOpen access · bronzeAbstract read
In one paragraph

Article in European heart journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04898062 (Randomized, Controlled, Proof-Of-Concept Trial of CRP-Apheresis for Attenuation of Pulmonary MYocardial and/or Kidney Injury in COvid-19), which is not on this map. Cited by 232 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
232citing papers in PubMed, 2 pooled it
7.8field-weighted citation impact, top 2% 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.

NCT04898062 nawithdrawnnot on this map

Randomized, Controlled, Proof-Of-Concept Trial of CRP-Apheresis for Attenuation of Pulmonary MYocardial and/or Kidney Injury in COvid-19

TypeinterventionalSponsorPentracor GmbHRan2021 to 2023Enrolled0ConditionsCovid19ArmsCRP-apheresis
3 · Its place in the literature

Who cites it

232 citing papers in PubMed, 2 syntheses or guidelines pooled it, 449 citations in OpenAlex.

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172 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Nathaniel R SmilowitzLeon H. Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, NY, USA.ORCID 0000-0002-6823-2815
Dennis KunichoffDepartment of Population Health, New York University Langone Health, New York, NY, USA.ORCID 0000-0001-8721-0534
Michael GarshickLeon H. Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, NY, USA.ORCID 0000-0002-6649-3755
Binita ShahLeon H. Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, NY, USA.
Michael PillingerDepartment of Medicine, VA New York Harbor Healthcare System, New York, NY, USA.
Judith S HochmanLeon H. Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, NY, USA.ORCID 0000-0002-5889-5981
Jeffrey S BergerLeon H. Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, NY, USA.
New York University · USVA NY Harbor Healthcare System · USNYU Langone Health · US

Funding

Project-005UL1TR001445 · NCATS · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI BREDELLA, MIRIAM ANTOINETTE, HOCHMAN, JUDITH S · 2015 to 2025
$103.5M
Mechanisms of Platelet Activity in Vascular DiseaseR35HL144993 · NHLBI · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI BERGER, JEFFREY S · 2019 to 2025
$5.5M
Platelet Activity and Vascular Health in Systemic Lupus ErythematosusR01HL139909 · NHLBI · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI BERGER, JEFFREY S, BUYON, JILL P · 2018 to 2022
$4.3M
Mechanisms of Coronary Microvascular DiseaseK23HL150315 · NHLBI · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI SMILOWITZ, NATHANIEL ROSSO · 2020 to 2024
$948k
NCATS NIH HHS UL1 TR001445NHLBI NIH HHS K23 HL150315NHLBI NIH HHS R01 HL139909NHLBI NIH HHS R35 HL144993
6 · The paper itself

Abstract

backgroundA systemic inflammatory response is observed in coronavirus disease 2019 (COVID-19). Elevated serum levels of C-reactive protein (CRP), a marker of systemic inflammation, are associated with severe disease in bacterial or viral infections. We aimed to explore associations between CRP concentration at initial hospital presentation and clinical outcomes in patients with COVID-19. METHODS AND

resultsConsecutive adults aged ≥18 years with COVID-19 admitted to a large New York healthcare system between 1 March and 8 April 2020 were identified. Patients with measurement of CRP were included. Venous thrombo-embolism (VTE), acute kidney injury (AKI), critical illness, and in-hospital mortality were determined for all patients. Among 2782 patients hospitalized with COVID-19, 2601 (93.5%) had a CRP measurement [median 108 mg/L, interquartile range (IQR) 53-169]. CRP concentrations above the median value were associated with VTE [8.3% vs. 3.4%; adjusted odds ratio (aOR) 2.33, 95% confidence interval (CI) 1.61-3.36], AKI (43.0% vs. 28.4%; aOR 2.11, 95% CI 1.76-2.52), critical illness (47.6% vs. 25.9%; aOR 2.83, 95% CI 2.37-3.37), and mortality (32.2% vs. 17.8%; aOR 2.59, 95% CI 2.11-3.18), compared with CRP below the median. A dose response was observed between CRP concentration and adverse outcomes. While the associations between CRP and adverse outcomes were consistent among patients with low and high D-dimer levels, patients with high D-dimer and high CRP have the greatest risk of adverse outcomes.

conclusionsSystemic inflammation, as measured by CRP, is strongly associated with VTE, AKI, critical illness, and mortality in COVID-19. CRP-based approaches to risk stratification and treatment should be tested.

Indexed as

COVID-19C-Reactive ProteinAdolescentAdultHumansRetrospective StudiesRisk FactorsSARS-CoV-2C-Reactive ProteinCoronavirusCOVID-19C-reactive proteinCritical illnessInflammationMortality

Identifiers

PMID33448289
PMCPMC7928982
OpenAlexW3125438608

What OpenQuestion holds

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Registered trials

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.