Procalcitonin and C-reactive protein to rule out early bacterial coinfection in COVID-19 critically ill patients

Autor segons l'article: Galli, Flavia; Bindo, Francesco; Motos, Anna; Fernandez-Barat, Laia; Barbeta, Enric; Gabarrus, Albert; Ceccato, Adrian; Bermejo-Martin, Jesus F; Ferrer, Ricard; Riera, Jordi; Penuelas, Oscar; Lorente, Jose Angel; de Gonzalo-Calvo, David; Menendez, Rosario; Gonzalez, Jessica; Misuraca, Sofia; Palomeque, Andrea; Amaya-Villar, Rosario; Anon, Jose Manuel; Balan Marino, Ana; Barbera, Carme; Barberan, Jose; Blandino Ortiz, Aaron; Bustamante-Munguira, Elena; Caballero, Jesus; Canton-Bulnes, Maria Luisa; Carbajales Perez, Cristina; Carbonell, Nieves; Catalan-Gonzalez, Mercedes; de Frutos, Raul; Franco, Nieves; Galban, Cristobal; Lopez Lago, Ana; Gumucio-Sanguino, Victor D; de la Torre, Maria del Carmen; Diaz, Emilio; Estella, Angel; Gallego Curto, Elena; Garcia-Garmendia, Jose Luis; Gomez, Jose Manuel; Huerta, Arturo; Jorge Garcia, Ruth Noemi; Loza-Vazquez, Ana; Marin-Corral, Judith; Martin Delgado, Maria Cruz; Martinez de la Gandara, Amalia; Martinez Varela, Ignacio; Lopez Messa, Juan; M Albaiceta, Guillermo; Nieto, Maria Teresa; Novo, Mariana Andrea; Penasco, Yhivian; Perez-Garcia, Felipe; Pozo-Laderas, Juan Carlos; Ricart, Pilar; Sagredo, Victor; Sanchez-Miralles, Angel; Sancho Chinesta, Susana; Roche-Campo, Ferran; Socias, Lorenzo; Sole-Violan, Jordi; Suarez-Sipmann, Fernando; Tamayo Lomas, Luis; Trenado, Jose; Ubeda, Alejandro; Valdivia, Luis Jorge; Vidal, Pablo; Boado, Maria Victoria; Rodriguez, Alejandro; Antonelli, Massimo; Blasi, Francesco; Barbe, Ferran; Torres, Antoni

Departament: Ciències Mèdiques Bàsiques

Autor/s de la URV: Rodríguez Oviedo, Alejandro Hugo

Paraules clau: Procalcitonin; Intensive care; Critically ill; Covid-19; Community-acquired pneumonia; C-reactive protein; Bacterial coinfection; statistics notes; serum procalcitonin; sepsis; mortality; intensive care; infection; etiology; diagnosis; decision; critically ill; covid-19; c-reactive protein; bacterial coinfection; adults

Resum: 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.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.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.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.© 2023. The Author(s).

Àrees temàtiques: Saúde coletiva; Odontología; Nutrição; Medicina iii; Medicina ii; Medicina i; Interdisciplinar; General medicine; Farmacia; Engenharias iv; Enfermagem; Emergency medicine & critical care; Educação física; Critical care medicine; Critical care and intensive care medicine; Ciências biológicas iii; Ciências biológicas ii; Ciências biológicas i

Accès a la llicència d'ús: https://creativecommons.org/licenses/by/3.0/es/

Adreça de correu electrònic de l'autor: alejandrohugo.rodriguez@urv.cat

Data d'alta del registre: 2025-01-27

Versió de l'article dipositat: info:eu-repo/semantics/publishedVersion

Enllaç font original: https://link.springer.com/article/10.1007/s00134-023-07161-1

Referència a l'article segons font original: Intensive Care Medicine. 49 (8): 934-945

Referència de l'ítem segons les normes APA: Galli, Flavia; Bindo, Francesco; Motos, Anna; Fernandez-Barat, Laia; Barbeta, Enric; Gabarrus, Albert; Ceccato, Adrian; Bermejo-Martin, Jesus F; Ferre (2023). Procalcitonin and C-reactive protein to rule out early bacterial coinfection in COVID-19 critically ill patients. Intensive Care Medicine, 49(8), 934-945. DOI: 10.1007/s00134-023-07161-1

URL Document de llicència: https://repositori.urv.cat/ca/proteccio-de-dades/

DOI de l'article: 10.1007/s00134-023-07161-1

Entitat: Universitat Rovira i Virgili

Any de publicació de la revista: 2023

Tipus de publicació: Journal Publications