Procalcitonin and C-reactive protein to rule out early bacterial coinfection in COVID-19 critically ill patients
Authors
Galli, Flavia; Bindo, Francesco; Motos, Anna; Fernández Barat, Laia; Barbeta, Enric; [et al.]Identifiers
Permanent link (URI): http://hdl.handle.net/10017/60932DOI: 10.1007/s00134-023-07161-1
ISSN: 0342-4642
Date
2023-07-28Embargo end date
2024-07-28Funders
Instituto de Salud Carlos III
FEDER
Fondo Social Europeo
CIBERES
UNESPA
Bibliographic citation
Intensive Care Medicine, 2023, v. 49, n. 8, p. 934-945
Keywords
Bacterial coinfection
C-reactive protein
COVID-19
Critically ill
Intensive care
Procalcitonin
Description / Notes
12 p.
Project
info:eu-repo/grantAgreement/ISCIII//COV20%00110/ES//
info:eu-repo/grantAgreement/ISCIII/Miguel Servet/CP20%00041/ES//
info:eu-repo/grantAgreement/ISCIII/Sara Borrell/ CD21%00087/ES//
Document type
info:eu-repo/semantics/article
Version
info:eu-repo/semantics/acceptedVersion
Rights
© 2023 The Author(s)
Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)
Access rights
info:eu-repo/semantics/embargoedAccess
Abstract
Purpose: Although the prevalence of community-acquired respiratory bacterial coinfection upon hospital admission in patients with coronavirus disease 2019 (COVID-19) has been reported to be < 5%, almost three-quarters of patients received antibiotics. We aim to investigate whether procalcitonin (PCT) or C-reactive protein (CRP) upon admission could be helpful biomarkers to identify bacterial coinfection among patients with COVID-19 pneumonia. Methods: We carried out a multicentre, observational cohort study including consecutive COVID-19 patients admitted to 55 Spanish intensive care units (ICUs). The primary outcome was to explore whether PCT or CRP serum levels upon hospital admission could predict bacterial coinfection among patients with COVID-19 pneumonia. The secondary outcome was the evaluation of their association with mortality. We also conducted subgroups analyses in higher risk profile populations. Results: Between 5 February 2020 and 21 December 2021, 4076 patients were included, 133 (3%) of whom presented bacterial coinfection. PCT and CRP had low area under curve (AUC) scores at the receiver operating characteristic (ROC) curve analysis [0.57 (95% confidence interval (CI) 0.51-0.61) and 0.6 (95% CI, 0.55-0.64), respectively], but high negative predictive values (NPV) [97.5% (95% CI 96.5-98.5) and 98.2% (95% CI 97.5-98.9) for PCT and CRP, respectively]. CRP alone was associated with bacterial coinfection (OR 2, 95% CI 1.25-3.19; p = 0.004). The overall 15, 30 and 90 days mortality had a higher trend in the bacterial coinfection group, but without significant difference. PCT ? 0.12 ng/mL was associated with higher 90 days mortality. Conclusion: Our study suggests that measurements of PCT and CRP, alone and at a single time point, are not useful for ruling in or out bacterial coinfection in viral pneumonia by COVID-19.
Files in this item
Files | Size | Format |
|
---|---|---|---|
procalcinotin_galli_IntensiveC ... | 1.381Mb |
|
Files | Size | Format |
|
---|---|---|---|
procalcinotin_galli_IntensiveC ... | 1.381Mb |
|
Collections
- MICROPAR - Artículos [137]
Related items
Showing items related by title, author, creator and subject.
-
Obeticholic acid reduces bacterial traslocation, restores intestinal barrier and inhibits inflammation in cirrhotic rats
Álvarez De Mon Soto, Melchor; Úbeda Cantera, María del Pilar; Lario Martínez, Margaret; Muñoz Zamarrón, María Leticia; Borrero Corte, María José; [et al.] (2016-05) -
An information literacy approach within the "Guided weekly reflection papers"
Quintanilla López, María Gloria; Copa Patiño, José Luis; Guerrero Baquero, Antonio; González-Santander Martínez, Marta; Hernández Romero, María Nieves; [et al.] (2015-06-02) -
Difusión de los resultados de la experiencia "Semanarios reflexivos" a través del repositorio de la UAH e-Buah
Quintanilla López, María Gloria; Copa Patiño, José Luis; Guerrero Baquero, Antonio; González-Santander Martínez, Marta; Hernández Romero, María Nieves; [et al.] (2017-07-10)