Last summer, Einstein-Montefiore researchers including Shitij Arora, M.D., reported that administering corticosteroids to COVID-19 patients with high levels of the inflammation C-reactive protein (CRP), was associated with reduced mortality; conversely, giving corticosteroids to patients with low CRP levels was associated with harm. Corticosteroids are now mainstay in managing critically ill patients with COVID-19. CRP can be measured via a common blood test.

Now, in a follow up study published online on February 17 in the Journal of Hospital Medicine, Dr. Arora and colleagues have found that declines in CRP following corticosteroid treatment are an early predictor of patient survival. Patients whose CRP levels fall by more than 50% within 48 hours after corticosteroid treatment are much more likely to survive than those patients whose CRP levels decline by less than 50%. This early biomarker of response to corticosteroid therapy could alert physicians to seek alternative or adjunct therapies for patients with elevated CRP levels who do not have a biomarker response to therapy.

Dr. Arora is an associate professor of medicine at Einstein, academic hospitalist at Montefiore and the corresponding author on the study. Zhu Cui, M.D., and Zachary Merritt, M.D., both residents at Montefiore are co-first authors.