Thematic Article
Volume 4 Issue 8 - 2020
C-Reactive Protein and Partial Oxygen Pressure in the Peripheral Blood Predict Hospital Admission in Patients with Covid-19 Infection Observed in Emergency Department
Kostic Irena1, Bonora Antonio1*, Olivato Alessia2, Melchioretto Barbara2, Zaccaria Eleonora1 and Maccagnani Antonio1
1Emergency and Intensive Care Department, University Hospital of Verona, Italy
2Postgraduate School of Emergency Medicine, University of Verona, Italy
*Corresponding Author: Bonora Antonio, Emergency and Intensive Care Department, Borgo Roma University Hospital, Verona, Italy.
Received: July 06, 2020; Published: July 31, 2020


Background: Coronavirus disease has been spreading around the world like a dramatic pandemic. The wide spectrum of clinical variability makes the identification of patients needing for timely hospitalization a crucial issue. Several studies have already assess the relationship between laboratory abnormalities and outcome in admitted patients, but none of these has been yet carried in acute setting.

Aim: The aim of this retrospective observational study was to investigate whether simple and easy to collect clinical and laboratory findings could have affected the admission in these patients.

Patients and Methods: We carried our study in the Emergency Department of the University of Verona (Italy) between 16th and 31st March 2020, considering all consecutive patients with SARS-CoV-2 detection by polymerase chain reaction in nasopharyngeal swab. Patients were then enrolled if fullfill one or more of these symptoms: fever equal or more than 38°, cough, shortness of breath, tachypnoea. In all patients accurate medical history wqs reported and blood gas analysis, laboratory examinations and chest x-rays were performed. After evaluation, physicians decided for patient discharge or admission. All discharge patients were followed until disease resolved without sequel.

Statistical analysis: Sensitivity, specifity, positive predictive value (PPV) and negative predictive value (NPV) were derived from the receiver operating characteristic (ROC) curves and analysed. The optimal cut-off values of biomarkers were established by ROC curves and cut-off values for each parameter affecting hospitalization were calculated from the areas under ROC curves (AUC). The groups were compared with Mann-Whitney test and proportion of patients with Chi-square test. Difference set at p < 0.05 was considered significant.

Results: Out of 190 positive for SARS-CoV-2, 109 symptomatic patients (69 males, 40 females; mean age 67 years, range 27 - 93) formed the study population. After ED evaluation, 86 patients (78.9%) were admitted, while 23 (21.1%) were discharged and then healed without sequel. The respective cut-off values of variables more significantly related with hospitalization were: age over 60 years, pO2 less than 70 mmHg, SpO2 less than 95%, CRP superior to 26 mg/l and positive chest x-rays (p < 0.001). We reported the higher hospitalization rate for pO2 (167 times) and CRP (108 times) respectively. Age over 75 years and pO2 less than 53 mmHg well predicted in-hospital death and ICU admission (p = 0.001).

Conclusion: Both pO2 and CRP could be simple and reliable predictor of admission in COVID-19 patients, while age and pO2 related with outcome.

Keywords: COVID-19 Infection; Emergency Department; Hospital Admission Rate; Laboratory Parameters; Predictor Factors


  1. Zhou F., et al. “Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study”. Lancet 20.6736 (2020). 
  2. WHO-China Joint Mission. “Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19), 2020”. 
  3. World Health Organization. “Coronavirus disease 2019 (COVID-19). Situation report-43” (2020). 
  4. Mattiuzzi C and Lippi G. “Which lessons shall we learn from the 2019 novel coronavirus outbreak?” Annals of Translational Medicine 8.3 (2020): 48.
  5. Zhang JJ., et al. “Clinical characteristics of 140 patients infected by SARS-CoV-2 in Wuhan, China”. Allergy 19 (2020). 
  6. Huang C., et al. “Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China”. Lancet 395.10223 (2020): 497-506.
  7. Chen N., et al. “Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study”. Lancet 395.10223 (2020): 507-513.
  8. Xu XW., et al. “Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-CoV-2) outside of Wuhan, China: retrospective case series”. British Medical Journal 368 (2020): m606.
  9. Lippi G and Plebani M. “Laboratory abnormalities in patients with COVID-19 infection”. Clinical Chemistry and Laboratory Medicine (2020).
  10. Deng Y., et al. “Clinical characteristics of fatal and recovered cases of coronavirus disease 2019 (COVID-19) in Wuhan, China: a retrospective study”. Chinese Medical Journal 20 (2020). 
  11. “Global Surveillance for COVID-19 caused by human infection with COVID-19 virus”. 
  12. Santolaya ME., et al. “C-reactive protein: a valuable aid for the management of febrile children with cancer and neutropenia”. Clinical Infectious Diseases 18 (1994): 589-595.
  13. Chen G., et al. “Clinical and immunologic features in severe and moderate Coronavirus Disease 2019”. Journal of Clinical Investigation 27 (2020). 
  14. Gao Y., et al. “Diagnostic utility of clinical laboratory data determinations for patients with the severe COVID-19”. Journal of Medical Virology 17 (2020). 
  15. Yang X., et al. “Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study”. The Lancet Respiratory Medicine 8.5 (2020):475-481. 
  16. Shen L., et al. “Clinical and laboratory-derived parameters of 119 hospitalized patients with coronavirus disease 2019 in Xiangyang, Hubei Province, China”. Journal of Infection (2020). 
  17. Perico L., et al. “Should COVID-19 concern nephrologists? Why and to what extent? The emerging impasse of angiotensin blockade”. Nephron 1.19 (2020). 
  18. Zhang L., et al. “Origin and evolution of the 2019 novel coronavirus”. Clinical Infectious Diseases (2020). 
  19. Lippi G., et al. “Relation between red blood cell distribution width and inflammatory biomarkers in a large cohort of unselected outpatients”. Archives of Pathology and Laboratory Medicine 133 (2009):628-632.
Citation: Bonora Antonio., et al. “C-Reactive Protein and Partial Oxygen Pressure in the Peripheral Blood Predict Hospital Admission in Patients with Covid-19 Infection Observed in Emergency Department”. EC Emergency Medicine and Critical Care 4.8 (2020): 125-131.

PubMed Indexed Article

EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005

EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777

EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347

EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478

EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253

EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033

EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992

EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505

EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793

EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211

EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047

EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560

EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318

EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819

EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840

EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344

EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476

EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658

EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489

EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278

EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108

EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571

EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333

EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883

EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001

EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937

EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723

EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726

EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603

EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646

EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616

EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290

EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226

EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812

EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268

News and Events

October Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the October issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for Upcoming Issue

Ecronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before November 08, 2021.

Certificate of Publication

Ecronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

Ecronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.

Immediate Assistance

The prime motto of this team is to clarify all the queries without any delay or hesitation to avoid the inconvenience. For immediate assistance on your queries please don't hesitate to drop an email to