C-reactive protein as the marker of COVID-19 severity at Sanjiwani general hospital, Gianyar, Bali in 2020

I. Gusti Ayu Putu Putri Ulandari, Putu Dyah Widyaningsih


Background: Coronavirus disease-2019 (COVID-19) is a novel coronavirus type infection disease that was first reported at Wuhan city, Hubei province, China in December 2019. Cases of COVID-19 in Indonesia were increasing, reaching up to 287,008 confirmed cases on 30th September 2020. Sanjiwani general hospital Gianyar, Bali, one of the COVID-19 referral hospital at Gianyar, Bali, has treated as many as 149 confirmed COVID-19 cases from August to October 2020. The most significant laboratory parameter associated with COVID-19 severity was C-reactive protein (CRP) and neutrophil to lymphocyte ratio (NLR).

Methods: This study is a descriptive cross-sectional study. Data were gathered through secondary data from the medical records using the total sampling method. Descriptive analyses were performed to describe the samples characteristics and to calculate the mean CRP level. Meanwhile, the chi-square test was done to investigate the association between CRP level and the severity level of COVID-19. The result is considered statistically significant if the p value is <0.05

Results: Most of the samples are >60 years old (24.4%), female (56.6%), and have diabetes mellitus as their comorbid (46,7%). The mean CRP level is 8.9 mg/L. CRP level >8.9 mg/l significantly affects COVID-19 patients’ severity with the p value of 0.000 (p<0.005). The higher the initial CRP level of COVID-19 patients, the higher the severity level will be.

Conclusions: There is an association between the increased CRP level at the beginning of hospital admission and the severity of COVID-19 patients.


COVID-19, CRP level, Severity, Cross-sectional

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Adityo S, Martin CR, Ceva WP, Widayat DS, Mira Y, Herikurniawan et al. Coronavirus Disease 2019. Tinjauan Literatur Terkini. Jurnal Penyakit Dalam Indonesia. 2020;7:1.

Coronavirus Update. 2020. Available from: Accessed on 12 Dec 2020.

Satuan Tugas Penanganan COVID-19. 2020. Available from: Accessed on 12 Dec 2020.

Info corona Bali. 2020. Available from: Accessed on 12 Dec 2020.

Yuliana. 2020. Corona Virus Disease (COVID-19); Sebuah Tinjauan Literatur. Wellness and Healthy Magazine. 2020;2(1):187-92.

Yusra, Natasha P. Pemeriksaan Laboratorium pada Coronavirus Disease 2019 (COVID-19). Medica Hospitalia J Clin Med. 2020;7(1A):304-19.

Cheng B, Hu J, Zuo X, Chen J, Li X, Chen Y et al. Predictors of Progression from Moderate to Severe Coronavirus Disease 2019: A Retrospective Cohort. Clin Microbiol Infect, Elsevier. 2020;26:1400-5.

Cevik M, Kuppalli K, Kindrachuk J, Peiris M. Virology, Transmission, and Pathogenesis of SARS-CoV-2. BMJ. 2020;371:m3862.

Mason RJ. Pathogenesis of COVID-19 from a Cell Biology Perspctive. Eur Respir J. 2020;552000607.

Erlina B, Agus DS, Sally AN, Eka G, Ceva WP, Adityo S et al. Pedoman Tatalaksana COVID-19 Edisi Ke-3. pdpi. perki. papdi. perdatin. idai. Jakarta, 2020.

Mudatsir M, Jonny KF, Laksmi W, Gatot S, Muhammad I, Yeni P et al. Predictors of COVID-19 Severity: A Systemtic Review and Meta-Analysis. F1000 Research. 2020;9:1107.

Yuki K, Fujiogi M, Sophia K. Review Article: COVID-19 Pathophysiology. Clin Immunol. 2020;215:108427.

Tan C, Ying H, Fengxia S, Kui T, Qionghui M, Yong C et al. C-Reactive Protein Correlates with Computed Tomographic Findings and Predicts Severe COVID-19 Early. J Med Virol Wiley. 2020;1-7.

Liu W, Tao ZW, Wang L, Yuan M, Liu K, Zhou L et al. Analysis of Factors Associated with Disease Outcomes in Hospitalized Patients With 2019 Novel Coronavirus Disease. Chinese Med J. 2020;133:9.

Sun Y, Dong Y, Wang L, Xie H, Li B, Chang C et al. Characteristics and Prognostic Factors of Disease Severity in Patients with COVID-19: The Beijing Experience. J Autoimmunity. 2020;112:102473.

Chen W, Zheng K, Liu S, Yan Z, Xu C, Qiao Z. 2020. Plasma CRP Level is Positively Associated with the Severity of COVID-19. Ann Clin Microbiol Antimicrobials. 2020;19:18.

Ahnach M, Zbiri S, Nejjari S, Ousti F, Elkettani C. C-Reactive Protein as an Early Predictor of COVID-19 Severity. Original Paper. J Med Biochem. 2020;39(4):500-7.

Sang W, Dong J, Ren Y, Tian M, Li W, Hu J et al. The Value of Clinical Parameters in Predicting the Severity of COVID-19. J Med Virol Wiley. 2020;922:2188-92.