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

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...

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Autores: Galli, Flavia, Bindo, Francesco, Motos, Ana|||0000-0002-3757-1232, Fernández Barat, Laia|||0000-0001-7528-9636, Barbeta, Enric|||0000-0001-9725-4100, Gabarrús, Albert|||0000-0003-3492-1310, Ceccato, Adrian|||0000-0001-9454-062X, Bermejo-Martin, Jesus F.|||0000-0002-7998-6268, Ferrer, Ricard|||0000-0002-4859-4747, Riera del Brio, Jordi|||0000-0002-1738-4448, Peñuelas, Oscar|||0000-0003-1484-3933, Lorente, José Ángel, Gonzalo Calvo, David de|||0000-0003-2240-3532, Menéndez, Rosario, González, Jéssica, Misuraca, Sofia, Palomeque, Andrea, Amaya-Villar, Rosario, Añón, José Manuel, Balan Mariño, Ana, Barberà, Carme, Barberán, José, Blandino Ortiz, Aaron|||0000-0002-3184-6418, Bustamante-Munguira, Elena, Caballero, Jesús|||0000-0001-9005-9687, Cantón-Bulnes, María Luisa, Carbajales Pérez, Cristina, Carbonell, Nieves|||0000-0002-9149-0310, Catalán-González, Mercedes, de Frutos, Raul, Franco, Nieves, Galbán, Cristóbal, Lopez Lago, Ana, Gumucio-Sanguino, Víctor D., de la Torre, Maria Del Carmen, Díaz Santos, Emilio|||0000-0003-3637-3821, Estella, Ángel|||0000-0003-0665-557X, Gallego Curto, Elena, García-Garmendia, José Luis, Gómez, José Manuel, Huerta, Arturo|||0000-0002-6191-4143, Jorge García, Ruth Noemí, Loza-Vázquez, Ana, Marin-Corral, Judith|||0000-0003-1320-4427, Martin Delgado, María Cruz, Martínez de la Gándara, Amalia, Martínez Varela, Ignacio, Lopez Messa, Juan, M. Albaiceta, Guillermo, Nieto, Maite, Novo, Mariana Andrea, Peñasco, Yhivian, Pérez-García, Felipe|||0000-0002-4885-4334, Pozo-Laderas, Juan Carlos, Ricart, Pilar|||0000-0003-0067-9132, Sagredo, Victor, Sánchez Miralles, Ángel, Sancho Chinesta, Susana, Roche-Campo, Ferran, Socias, Lorenzo, Solé-Violan, Jordi, Suarez-Sipmann, Fernando|||0000-0002-7412-2970, Tamayo Lomas, Luis, Trenado, José, Úbeda, Alejandro, Valdivia, Luis Jorge, Vidal, Pablo, Boado Varela, Maria Victoria, Rodríguez, Alejandro, Antonelli, Massimo|||0000-0003-3007-1670, Blasi, Francesco|||0000-0002-2285-9970, Barbé, Ferran|||0000-0002-2340-8928, Torres, Antoni|||0000-0002-8643-2167
Formato: artículo
Fecha de publicación:2023
País:España
Recursos:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:290196
Acesso em linha:https://ddd.uab.cat/record/290196
https://dx.doi.org/urn:doi:10.1007/s00134-023-07161-1
Access Level:acceso abierto
Palavra-chave:Bacterial coinfection
COVID-19
Critically ill
C-reactive protein
Intensive care
Procalcitonin
id ES_355756f0f942e2c4c7413613201badba
oai_identifier_str oai:ddd.uab.cat:290196
network_acronym_str ES
network_name_str España
repository_id_str
dc.title.none.fl_str_mv Procalcitonin and C-reactive protein to rule out early bacterial coinfection in COVID-19 critically ill patients
title Procalcitonin and C-reactive protein to rule out early bacterial coinfection in COVID-19 critically ill patients
spellingShingle Procalcitonin and C-reactive protein to rule out early bacterial coinfection in COVID-19 critically ill patients
Galli, Flavia
Bacterial coinfection
COVID-19
Critically ill
C-reactive protein
Intensive care
Procalcitonin
title_short Procalcitonin and C-reactive protein to rule out early bacterial coinfection in COVID-19 critically ill patients
title_full Procalcitonin and C-reactive protein to rule out early bacterial coinfection in COVID-19 critically ill patients
title_fullStr Procalcitonin and C-reactive protein to rule out early bacterial coinfection in COVID-19 critically ill patients
title_full_unstemmed Procalcitonin and C-reactive protein to rule out early bacterial coinfection in COVID-19 critically ill patients
title_sort Procalcitonin and C-reactive protein to rule out early bacterial coinfection in COVID-19 critically ill patients
dc.creator.none.fl_str_mv Galli, Flavia
Bindo, Francesco
Motos, Ana|||0000-0002-3757-1232
Fernández Barat, Laia|||0000-0001-7528-9636
Barbeta, Enric|||0000-0001-9725-4100
Gabarrús, Albert|||0000-0003-3492-1310
Ceccato, Adrian|||0000-0001-9454-062X
Bermejo-Martin, Jesus F.|||0000-0002-7998-6268
Ferrer, Ricard|||0000-0002-4859-4747
Riera del Brio, Jordi|||0000-0002-1738-4448
Peñuelas, Oscar|||0000-0003-1484-3933
Lorente, José Ángel
Gonzalo Calvo, David de|||0000-0003-2240-3532
Menéndez, Rosario
González, Jéssica
Misuraca, Sofia
Palomeque, Andrea
Amaya-Villar, Rosario
Añón, José Manuel
Balan Mariño, Ana
Barberà, Carme
Barberán, José
Blandino Ortiz, Aaron|||0000-0002-3184-6418
Bustamante-Munguira, Elena
Caballero, Jesús|||0000-0001-9005-9687
Cantón-Bulnes, María Luisa
Carbajales Pérez, Cristina
Carbonell, Nieves|||0000-0002-9149-0310
Catalán-González, Mercedes
de Frutos, Raul
Franco, Nieves
Galbán, Cristóbal
Lopez Lago, Ana
Gumucio-Sanguino, Víctor D.
de la Torre, Maria Del Carmen
Díaz Santos, Emilio|||0000-0003-3637-3821
Estella, Ángel|||0000-0003-0665-557X
Gallego Curto, Elena
García-Garmendia, José Luis
Gómez, José Manuel
Huerta, Arturo|||0000-0002-6191-4143
Jorge García, Ruth Noemí
Loza-Vázquez, Ana
Marin-Corral, Judith|||0000-0003-1320-4427
Martin Delgado, María Cruz
Martínez de la Gándara, Amalia
Martínez Varela, Ignacio
Lopez Messa, Juan
M. Albaiceta, Guillermo
Nieto, Maite
Novo, Mariana Andrea
Peñasco, Yhivian
Pérez-García, Felipe|||0000-0002-4885-4334
Pozo-Laderas, Juan Carlos
Ricart, Pilar|||0000-0003-0067-9132
Sagredo, Victor
Sánchez Miralles, Ángel
Sancho Chinesta, Susana
Roche-Campo, Ferran
Socias, Lorenzo
Solé-Violan, Jordi
Suarez-Sipmann, Fernando|||0000-0002-7412-2970
Tamayo Lomas, Luis
Trenado, José
Úbeda, Alejandro
Valdivia, Luis Jorge
Vidal, Pablo
Boado Varela, Maria Victoria
Rodríguez, Alejandro
Antonelli, Massimo|||0000-0003-3007-1670
Blasi, Francesco|||0000-0002-2285-9970
Barbé, Ferran|||0000-0002-2340-8928
Torres, Antoni|||0000-0002-8643-2167
author Galli, Flavia
author_facet Galli, Flavia
Bindo, Francesco
Motos, Ana|||0000-0002-3757-1232
Fernández Barat, Laia|||0000-0001-7528-9636
Barbeta, Enric|||0000-0001-9725-4100
Gabarrús, Albert|||0000-0003-3492-1310
Ceccato, Adrian|||0000-0001-9454-062X
Bermejo-Martin, Jesus F.|||0000-0002-7998-6268
Ferrer, Ricard|||0000-0002-4859-4747
Riera del Brio, Jordi|||0000-0002-1738-4448
Peñuelas, Oscar|||0000-0003-1484-3933
Lorente, José Ángel
Gonzalo Calvo, David de|||0000-0003-2240-3532
Menéndez, Rosario
González, Jéssica
Misuraca, Sofia
Palomeque, Andrea
Amaya-Villar, Rosario
Añón, José Manuel
Balan Mariño, Ana
Barberà, Carme
Barberán, José
Blandino Ortiz, Aaron|||0000-0002-3184-6418
Bustamante-Munguira, Elena
Caballero, Jesús|||0000-0001-9005-9687
Cantón-Bulnes, María Luisa
Carbajales Pérez, Cristina
Carbonell, Nieves|||0000-0002-9149-0310
Catalán-González, Mercedes
de Frutos, Raul
Franco, Nieves
Galbán, Cristóbal
Lopez Lago, Ana
Gumucio-Sanguino, Víctor D.
de la Torre, Maria Del Carmen
Díaz Santos, Emilio|||0000-0003-3637-3821
Estella, Ángel|||0000-0003-0665-557X
Gallego Curto, Elena
García-Garmendia, José Luis
Gómez, José Manuel
Huerta, Arturo|||0000-0002-6191-4143
Jorge García, Ruth Noemí
Loza-Vázquez, Ana
Marin-Corral, Judith|||0000-0003-1320-4427
Martin Delgado, María Cruz
Martínez de la Gándara, Amalia
Martínez Varela, Ignacio
Lopez Messa, Juan
M. Albaiceta, Guillermo
Nieto, Maite
Novo, Mariana Andrea
Peñasco, Yhivian
Pérez-García, Felipe|||0000-0002-4885-4334
Pozo-Laderas, Juan Carlos
Ricart, Pilar|||0000-0003-0067-9132
Sagredo, Victor
Sánchez Miralles, Ángel
Sancho Chinesta, Susana
Roche-Campo, Ferran
Socias, Lorenzo
Solé-Violan, Jordi
Suarez-Sipmann, Fernando|||0000-0002-7412-2970
Tamayo Lomas, Luis
Trenado, José
Úbeda, Alejandro
Valdivia, Luis Jorge
Vidal, Pablo
Boado Varela, Maria Victoria
Rodríguez, Alejandro
Antonelli, Massimo|||0000-0003-3007-1670
Blasi, Francesco|||0000-0002-2285-9970
Barbé, Ferran|||0000-0002-2340-8928
Torres, Antoni|||0000-0002-8643-2167
author_role author
author2 Bindo, Francesco
Motos, Ana|||0000-0002-3757-1232
Fernández Barat, Laia|||0000-0001-7528-9636
Barbeta, Enric|||0000-0001-9725-4100
Gabarrús, Albert|||0000-0003-3492-1310
Ceccato, Adrian|||0000-0001-9454-062X
Bermejo-Martin, Jesus F.|||0000-0002-7998-6268
Ferrer, Ricard|||0000-0002-4859-4747
Riera del Brio, Jordi|||0000-0002-1738-4448
Peñuelas, Oscar|||0000-0003-1484-3933
Lorente, José Ángel
Gonzalo Calvo, David de|||0000-0003-2240-3532
Menéndez, Rosario
González, Jéssica
Misuraca, Sofia
Palomeque, Andrea
Amaya-Villar, Rosario
Añón, José Manuel
Balan Mariño, Ana
Barberà, Carme
Barberán, José
Blandino Ortiz, Aaron|||0000-0002-3184-6418
Bustamante-Munguira, Elena
Caballero, Jesús|||0000-0001-9005-9687
Cantón-Bulnes, María Luisa
Carbajales Pérez, Cristina
Carbonell, Nieves|||0000-0002-9149-0310
Catalán-González, Mercedes
de Frutos, Raul
Franco, Nieves
Galbán, Cristóbal
Lopez Lago, Ana
Gumucio-Sanguino, Víctor D.
de la Torre, Maria Del Carmen
Díaz Santos, Emilio|||0000-0003-3637-3821
Estella, Ángel|||0000-0003-0665-557X
Gallego Curto, Elena
García-Garmendia, José Luis
Gómez, José Manuel
Huerta, Arturo|||0000-0002-6191-4143
Jorge García, Ruth Noemí
Loza-Vázquez, Ana
Marin-Corral, Judith|||0000-0003-1320-4427
Martin Delgado, María Cruz
Martínez de la Gándara, Amalia
Martínez Varela, Ignacio
Lopez Messa, Juan
M. Albaiceta, Guillermo
Nieto, Maite
Novo, Mariana Andrea
Peñasco, Yhivian
Pérez-García, Felipe|||0000-0002-4885-4334
Pozo-Laderas, Juan Carlos
Ricart, Pilar|||0000-0003-0067-9132
Sagredo, Victor
Sánchez Miralles, Ángel
Sancho Chinesta, Susana
Roche-Campo, Ferran
Socias, Lorenzo
Solé-Violan, Jordi
Suarez-Sipmann, Fernando|||0000-0002-7412-2970
Tamayo Lomas, Luis
Trenado, José
Úbeda, Alejandro
Valdivia, Luis Jorge
Vidal, Pablo
Boado Varela, Maria Victoria
Rodríguez, Alejandro
Antonelli, Massimo|||0000-0003-3007-1670
Blasi, Francesco|||0000-0002-2285-9970
Barbé, Ferran|||0000-0002-2340-8928
Torres, Antoni|||0000-0002-8643-2167
author2_role author
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dc.contributor.none.fl_str_mv Universitat Autònoma de Barcelona
dc.subject.none.fl_str_mv Bacterial coinfection
COVID-19
Critically ill
C-reactive protein
Intensive care
Procalcitonin
topic Bacterial coinfection
COVID-19
Critically ill
C-reactive protein
Intensive care
Procalcitonin
description 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.
publishDate 2023
dc.date.none.fl_str_mv 2
2023-01-01
2023
2023-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/290196
https://dx.doi.org/urn:doi:10.1007/s00134-023-07161-1
url https://ddd.uab.cat/record/290196
https://dx.doi.org/urn:doi:10.1007/s00134-023-07161-1
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by-nc/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by-nc/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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spelling Procalcitonin and C-reactive protein to rule out early bacterial coinfection in COVID-19 critically ill patientsGalli, FlaviaBindo, FrancescoMotos, Ana|||0000-0002-3757-1232Fernández Barat, Laia|||0000-0001-7528-9636Barbeta, Enric|||0000-0001-9725-4100Gabarrús, Albert|||0000-0003-3492-1310Ceccato, Adrian|||0000-0001-9454-062XBermejo-Martin, Jesus F.|||0000-0002-7998-6268Ferrer, Ricard|||0000-0002-4859-4747Riera del Brio, Jordi|||0000-0002-1738-4448Peñuelas, Oscar|||0000-0003-1484-3933Lorente, José ÁngelGonzalo Calvo, David de|||0000-0003-2240-3532Menéndez, RosarioGonzález, JéssicaMisuraca, SofiaPalomeque, AndreaAmaya-Villar, RosarioAñón, José ManuelBalan Mariño, AnaBarberà, CarmeBarberán, JoséBlandino Ortiz, Aaron|||0000-0002-3184-6418Bustamante-Munguira, ElenaCaballero, Jesús|||0000-0001-9005-9687Cantón-Bulnes, María LuisaCarbajales Pérez, CristinaCarbonell, Nieves|||0000-0002-9149-0310Catalán-González, Mercedesde Frutos, RaulFranco, NievesGalbán, CristóbalLopez Lago, AnaGumucio-Sanguino, Víctor D.de la Torre, Maria Del CarmenDíaz Santos, Emilio|||0000-0003-3637-3821Estella, Ángel|||0000-0003-0665-557XGallego Curto, ElenaGarcía-Garmendia, José LuisGómez, José ManuelHuerta, Arturo|||0000-0002-6191-4143Jorge García, Ruth NoemíLoza-Vázquez, AnaMarin-Corral, Judith|||0000-0003-1320-4427Martin Delgado, María CruzMartínez de la Gándara, AmaliaMartínez Varela, IgnacioLopez Messa, JuanM. Albaiceta, GuillermoNieto, MaiteNovo, Mariana AndreaPeñasco, YhivianPérez-García, Felipe|||0000-0002-4885-4334Pozo-Laderas, Juan CarlosRicart, Pilar|||0000-0003-0067-9132Sagredo, VictorSánchez Miralles, ÁngelSancho Chinesta, SusanaRoche-Campo, FerranSocias, LorenzoSolé-Violan, JordiSuarez-Sipmann, Fernando|||0000-0002-7412-2970Tamayo Lomas, LuisTrenado, JoséÚbeda, AlejandroValdivia, Luis JorgeVidal, PabloBoado Varela, Maria VictoriaRodríguez, AlejandroAntonelli, Massimo|||0000-0003-3007-1670Blasi, Francesco|||0000-0002-2285-9970Barbé, Ferran|||0000-0002-2340-8928Torres, Antoni|||0000-0002-8643-2167Bacterial coinfectionCOVID-19Critically illC-reactive proteinIntensive careProcalcitoninAlthough 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.Universitat Autònoma de Barcelona 22023-01-0120232023-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/290196https://dx.doi.org/urn:doi:10.1007/s00134-023-07161-1reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.https://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:2901962026-06-06T12:50:31Z
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