| Title: |
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; Gabarrús, Albert; Ceccato, Adrián; Bermejo Martín, Jesús Francisco; Ferrer Roca, Ricard; Riera del Brío, Jordi; Peñuelas, Oscar; Lorente Balanza, José Ángel; Gonzalo Calvo, David de; Menéndez, Rosario; González, Jessica; Misuraca, Sofia; Palomeque, Andrea; Amaya Villar, Rosario; Añón Elizalde, José Manuel; Balan Mariño, Ana; Barberà, Carme; Barberán, José; Blandino Ortiz, Aaron Rolando; Bustamante Munguira, Elena; Caballero, Jesús; Cantón Bulnes, María Luisa; Carbajales Pérez, Cristina; Carbonell, Nieves; Catalán González, Mercedes; Frutos, Raúl de; Franco, Nieves; Galbán, Cristóbal; López Lago, Ana; Gumucio Sanguino, Victor Daniel; Torre, María del Carmen de la; Díaz, Emilio; Estella, Ángel; Gallego Curto, Elena; García Garmendia, José Luis; Gómez Pérez, José Manuel; Huerta, Arturo; Jorge García, Ruth Noemí; Loza Vázquez, Ana; Marin Corral, Judith; Martín Delgado, María Cruz; Martínez de la Gándara, Amalia; Martínez Varela, Ignacio; López Messa, Juan; Albaiceta, Guillermo M.; Nieto, María Teresa; Novo, Mariana Andrea; Peñasco Martín, Yhivian; Pérez García, Felipe; Pozo Laderas, Juan Carlos; Ricart Martí, Pilar; Sagredo Meneses, Víctor; Sánchez Miralles, Angel; Sancho Chinesta, Susana; Roche Campo, Ferran; Socias Crespí, Lorenzo; Solé Violan, Jordi; Suarez Sipmann, Fernando; Tamayo Lomas, Luis; Trenado, Josep; Úbeda Iglesias, Alejandro; Valdivia, Luis Jorge; Vidal Cortés, Pablo; Boado Varela, María Victoria; Rodriguez, Alejandro; Antonelli, Massimo; Blasi, Francesco; Barbé Illa, Ferran; Torres, Antoni |
| Contributors: |
Universidad de Alcalá. Departamento de Biomedicina y Biotecnología; Unidad Docente de Microbiología y Parasitología |
| Publication Year: |
2023 |
| Collection: |
e_Buah - Biblioteca Digital de la Universidad de Alcalá |
| Subject Terms: |
Bacterial coinfection; C-reactive protein; COVID-19; Critically ill; Intensive care; Procalcitonin; Biología y Biomedicina/Biología; Biology |
| Description: |
12 p. ; 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. ; Instituto de Salud Carlos III ; FEDER ; Fondo Social Europeo ; CIBERES ; UNESPA |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
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//; https://hdl.handle.net/10017/60932; AR/0000047113; Intensive Care Medicine; 49; 945; 934 |
| DOI: |
10.1007/s00134-023-07161-1 |
| Availability: |
https://hdl.handle.net/10017/60932; https://doi.org/10.1007/s00134-023-07161-1 |
| Rights: |
© 2023 The Author(s) ; Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) ; http://creativecommons.org/licenses/by-nc-nd/4.0/ ; info:eu-repo/semantics/openAccess |
| Accession Number: |
edsbas.855023FA |
| Database: |
BASE |