Aims

To understand whether the level of a protein that circulates in the blood, called C-reactive protein (CRP), is associated with poorer outcomes in Covid-19 patients. The study will also explore whether CRP should be treated to improve patient outcomes.

Background

C-reactive protein is a normal protein in the circulating blood.  It is made by the liver and increases in response to any infection or inflammation.  Its production increases dramatically during almost all active diseases and especially when there is damage to the body.  The concentration of CRP in the blood usually closely reflects the activity of disease and the extent of tissue damage.  In hospitalised patients with COVID-19 infections the levels of CRP can be extremely high.

Initially it was thought that CRP was a marker of active disease and inflammation, but did not contribute to any tissue or organ damage. However, recent scientific studies have shown that large amounts of CRP in the blood can damage tissues, especially if they are already injured by infection or inflammation. For example, CRP has been linked to blood clots in the blood vessels and to kidney injury in those with already damaged kidneys.  There are now a number of programmes to assess whether high levels of CRP should be treated, with drugs which target CRP and reduce the levels in the body.

As CRP levels can be very high in COVID-19, it may also be contributing to tissue injury and poor outcomes for patients.

Research

Researchers at University College London led by Dr Schmidt, Professor Sir Mark Pepys and Professor Hingorani, will use health data curated by PIONEER to understand whether CRP levels are associated with poor outcomes and to explore whether CRP should be treated in those with COVID-19, to improve patient outcomes.

Working with patients, clinicians and healthcare providers, the team will analyse this health data, and share their findings with patients, researchers and the medical community. The results will help to improve the treatment of future patients with COVID-19.

Patient involvement

Patient groups will discuss data models as they are created. Clinical questions will be discussed directly with patients at a later date.

Approval

This project was supported unanimously by the PIONEER Data Trust Committee.

Principal investigator

Dr Amand Floriaan Schmidt, University College London

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