Study of CRP, Ferritin and D-Dimer in Covid-19 RICU Patients as per HRCT severity in Assiut University Hospitals

Background Patients with Coronavirus disease (COVID-19) was found to exhibit elevated levels of inflammatory cytokines, which were linked to pulmonary inflammation, lung damage, and end with multi-organ failure.C-reactive protein (CRP), serum ferritin and D dimer levels may predict severity and mortality. Radiology plays a key role in the diagnosis, management, and follow-up of this disease. We attempted to describe the radiological features of SARS-CoV-2 infection in its original form, to correlate the HRCT patterns with clinical findings, C-reactive protein (CRP), D-dimer and ferritin and to consider as predictors of morbidity and mortality in adult (ICU) patients with COVID-19. Methods This prospective cross-sectional analytic work had been conducted on 159 patients aged ≥ 18 years old, admitted at Assiut University Hospital Respiratory ICU from November 2021 to November 2022, diagnosed as COVID-19 by positive RT-PCR. All cases were categorized on bases of (HRCT chest) disease reporting and data system (CO-RADS) scoring classification.Oxygen saturation, and inflammatory markers such as CRP, Ferritin and D dimer were measured. Age, sex, comorbidities, use of MV mechanical ventilation, and outcomes as per HRCT severity were key observations. Results A total of 159 HRCT chest scans of symptomatic RT-PCR-positive ICU patients were recruited. Higher CRP and Ferritinserum levels, lower lymphocytic count, higher frequency of need for mechanical ventilation were significantly greater in the severe group as assessed by HRCT severity score (CORAD 4,5) (P < 0.0001)). Predictors of severity revealedCRP at cut off > 133 mg/dlserum level, had 65.7% overall accuracywith AUC: 0.673(OR:2.19(P < 0.0001)),DM (OR:3.45(P < 0.0001)), chronic chest disease (OR:2.22(P < 0.0001)). Mortality predictors were age (OR:1.78(P < 0.0001)), DM (OR:2.89(P < 0.0001)), chronic chest disease (OR:3.01(P < 0.0001)), serum CRP levels (OR:2.11(P < 0.0001)). Need for mechanical ventilation and mortality rate as regards CT severity score were 76(66%),75 (65%), versus 3(7%) 4(9%) between severe and non-severe groups respectively (P < 0.0001). Conclusions High-resolution computed tomography (HRCT) scan of the chest as well as CRP and ferritin plasma levels are valuable methodsand significant predictors for future prognosis in patients with covid19 at risk of death and in need for MV.