{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T01:46:27Z","timestamp":1782956787385,"version":"3.54.5"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T00:00:00Z","timestamp":1778025600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"vor","delay-in-days":57,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Tuberculosis (TB) remains a leading cause of global mortality, underscoring the need for accessible prognostic tools. C-reactive protein (CRP) is a widely available acute-phase biomarker that may predict outcomes in TB. This systematic review and meta-analysis assessed the prognostic value of baseline CRP in predicting mortality among adults with TB.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Eligible studies included cohort studies, observational studies, and control arms of randomized controlled trials involving adults (\u2265\u200918 years) with microbiologically confirmed TB. The exposure of interest was baseline CRP level, and the primary outcome was mortality, reported as adjusted hazard ratios (aHRs) or odds ratios (aORs). Data extraction followed the CHARMS-PF checklist. Risk of bias was assessed using the QUIPS, while certainty of evidence was evaluated using GRADE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From 1,277 records, nine studies met the inclusion criteria (three retrospective cohorts, three prospective cohorts, and three case-control studies) conducted in Japan, China, South Korea, Chinese Taipei, and South Africa. Five studies reported significant associations between elevated baseline CRP and increased mortality. In pooled analyses, three studies reporting aORs showed a modest but statistically significant association between higher baseline CRP and mortality (aOR 1.07, 95% CI 1.03\u20131.11; I\u00b2=0%). In contrast, pooled aHRs from four studies (aHR 1.02, 95% CI 0.99\u20131.05; I\u00b2=60%) and pooled cHRs from two studies (cHR 1.75, 95% CI 0.58\u20135.29; I\u00b2=91%) were not statistically significant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Baseline CRP showed a modest association with mortality in pooled aOR analyses, but not in pooled hazard ratio analyses. Nevertheless, its low cost and wide availability suggest potential utility as part of multimodal prognostic models, especially in high-risk populations and resource-limited settings. High-quality prospective studies with standardized CRP protocols are needed to clarify its prognostic role.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p>PROSPERO (CRD420251101984).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12879-026-13462-9","type":"journal-article","created":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T03:05:20Z","timestamp":1778036720000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["C-reactive protein as a predictor of mortality in tuberculosis: systematic review and meta-analysis"],"prefix":"10.1186","volume":"26","author":[{"given":"Jessica","family":"Edelyne","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Prasetio","family":"Wardoyo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luthfiyah Zanida","family":"Putri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salsabila","family":"Hulwani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Assica Permata Amalya","family":"Hakiman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. 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The supplementary Information can be assessed in the supplementary material file.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Supplementary information"}},{"value":"The systematic review protocol for this study, titled \u201cPrognostic Performance of C-reactive Protein for Tuberculosis Outcome,\u201d was prospectively registered on the International Prospective Register of Systematic Reviews (PROSPERO). The registration number is CRD420251101984. The full protocol is publicly accessible.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Registration and protocol"}},{"value":"ChatGPT 5.2 (OpenAI) was used during manuscript preparation for language refinement and editorial assistance. All outputs were reviewed, revised, and verified by the authors, who take full responsibility for the final content.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Use of generative AI"}},{"value":"The authors declare no competing interests.","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1205"}}