Details

Autor(en) / Beteiligte

• Carbonell, Raquel
• Urgelés, Silvia
• Salgado, Melina
• Rodríguez, Alejandro
• Reyes, Luis Felipe
• Fuentes, Yuli V.
• Serrano, Cristian C.
• Caceres, Eder L.
• Bodí, María
• Martín-Loeches, Ignacio
• Solé-Violán, Jordi
• Díaz, Emili
• Gómez, Josep
• Trefler, Sandra
• Vallverdú, Montserrat
• Murcia, Josefa
• Albaya, Antonio
• Loza, Ana
• Socias, Lorenzo
• Ballesteros, Juan Carlos
• Papiol, Elisabeth
• Viña, Lucía
• Sancho, Susana
• Nieto, Mercedes
• del, M
• Lorente, Carmen
• Badallo, Oihane
• Fraile, Virginia
• Arméstar, Fernando
• Estella, Angel
• Abanses, Paula
• Sancho, Isabel
• Guasch, Neus
• Moreno, Gerard

Titel

Negative predictive value of procalcitonin to rule out bacterial respiratory co-infection in critical covid-19 patients

Ist Teil von

• The Journal of infection, 2022-10, Vol.85 (4), p.374-381

Ort / Verlag

The British Infection Association. Published by Elsevier Ltd

Erscheinungsjahr

2022

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• BACKGROUNDProcalcitonin (PCT) and C-Reactive Protein (CRP) are useful biomarkers to differentiate bacterial from viral or fungal infections, although the association between them and co-infection or mortality in COVID-19 remains unclear. METHODSThe study represents a retrospective cohort study of patients admitted for COVID-19 pneumonia to 84 ICUs from ten countries between (March 2020-January 2021). Primary outcome was to determine whether PCT or CRP at admission could predict community-acquired bacterial respiratory co-infection (BC) and its added clinical value by determining the best discriminating cut-off values. Secondary outcome was to investigate its association with mortality. To evaluate the main outcome, a binary logistic regression was performed. The area under the curve evaluated diagnostic performance for BC prediction. RESULTS4635 patients were included, 7.6% fulfilled BC diagnosis. PCT (0.25[IQR 0.1-0.7] versus 0.20[IQR 0.1-0.5]ng/mL, p<0.001) and CRP (14.8[IQR 8.2-23.8] versus 13.3 [7-21.7]mg/dL, p=0.01) were higher in BC group. Neither PCT nor CRP were independently associated with BC and both had a poor ability to predict BC (AUC for PCT 0.56, for CRP 0.54). Baseline values of PCT<0.3ng/mL, could be helpful to rule out BC (negative predictive value 91.1%) and PCT≥0.50ng/mL was associated with ICU mortality (OR 1.5,p<0.001). CONCLUSIONSThese biomarkers at ICU admission led to a poor ability to predict BC among patients with COVID-19 pneumonia. Baseline values of PCT<0.3ng/mL may be useful to rule out BC, providing clinicians a valuable tool to guide antibiotic stewardship and allowing the unjustified overuse of antibiotics observed during the pandemic, additionally PCT≥0.50ng/mL might predict worsening outcomes.