Procalcitonin and C-reactive protein to rule out early bacterial coinfection in COVID-19 critically ill patients
PurposeAlthough 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 (PC...
| Autores: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2023 |
| País: | España |
| Institución: | Institut d'Investigació i Innovació Parc Taulí (I3PT) |
| Repositorio: | r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí |
| OAI Identifier: | oai:i3pt.fundanetsuite.com:p3697 |
| Acceso en línea: | https://i3pt.portalinvestigacion.com/publicaciones/3697 https://www.scopus.com/inward/record.uri?eid=2-s2.0-85166022159&doi=10.1007%2fs00134-023-07161-1&partnerID=40&md5=293348230823059c2f73398310602a3d |
| Access Level: | acceso abierto |
| Palabra clave: | Procalcitonin C-reactive protein COVID-19 Bacterial coinfection Critically ill Intensive care |
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Procalcitonin and C-reactive protein to rule out early bacterial coinfection in COVID-19 critically ill patientsGalli, FBindo, FMotos, AFernandez-Barat, LBarbeta, EGabarrus, ACeccato, ABermejo-Martin, JFFerrer, RRiera, JPenuelas, OLorente, JAde Gonzalo-Calvo, DMenendez, RGonzalez, JMisuraca, SPalomeque, AAmaya-Villar, RAnon, JMMarino, ABBarbera, CBarberan, JOrtiz, ABBustamante-Munguira, ECaballero, JCanton-Bulnes, MLPerez, CCCarbonell, NCatalan-Gonzalez, Mde Frutos, RFranco, NGalban, CLago, ALGumucio-Sanguino, VDde la Torre, MDDiaz, EEstella, ACurto, EGGarcia-Garmendia, JLGomez, JMHuerta, AGarcia, RNJLoza-Vazquez, AMarin-Corral, JDelgado, MCMde la Gandara, AMVarela, IMMessa, JLAlbaiceta, GMNieto, MTNovo, MAPenasco, YPerez-Garcia, FPozo-Laderas, JCRicart, PSagredo, VSanchez-Miralles, AChinesta, SSRoche-Campo, FSocias, LSole-Violan, JSuarez-Sipmann, FLomas, LTTrenado, JUbeda, AValdivia, LJVidal, PBoado, MVRodriguez, AAntonelli, MBlasi, FBarbe, FTorres, AProcalcitoninC-reactive proteinCOVID-19Bacterial coinfectionCritically illIntensive carePurposeAlthough 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.MethodsWe 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.ResultsBetween 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 & GE; 0.12 ng/mL was associated with higher 90 days mortality.ConclusionOur 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.SPRINGER2023info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://i3pt.portalinvestigacion.com/publicaciones/3697https://www.scopus.com/inward/record.uri?eid=2-s2.0-85166022159&doi=10.1007%2fs00134-023-07161-1&partnerID=40&md5=293348230823059c2f73398310602a3dINTENSIVE CARE MEDICINEISSN: 03424642ISSNe: 14321238reponame:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulíinstname:Institut d'Investigació i Innovació Parc Taulí (I3PT)Inglésinfo:eu-repo/semantics/openAccessoai:i3pt.fundanetsuite.com:p36972026-06-21T15:30:37Z |
| 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, F Procalcitonin C-reactive protein COVID-19 Bacterial coinfection Critically ill Intensive care |
| 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, F Bindo, F Motos, A Fernandez-Barat, L Barbeta, E Gabarrus, A Ceccato, A Bermejo-Martin, JF Ferrer, R Riera, J Penuelas, O Lorente, JA de Gonzalo-Calvo, D Menendez, R Gonzalez, J Misuraca, S Palomeque, A Amaya-Villar, R Anon, JM Marino, AB Barbera, C Barberan, J Ortiz, AB Bustamante-Munguira, E Caballero, J Canton-Bulnes, ML Perez, CC Carbonell, N Catalan-Gonzalez, M de Frutos, R Franco, N Galban, C Lago, AL Gumucio-Sanguino, VD de la Torre, MD Diaz, E Estella, A Curto, EG Garcia-Garmendia, JL Gomez, JM Huerta, A Garcia, RNJ Loza-Vazquez, A Marin-Corral, J Delgado, MCM de la Gandara, AM Varela, IM Messa, JL Albaiceta, GM Nieto, MT Novo, MA Penasco, Y Perez-Garcia, F Pozo-Laderas, JC Ricart, P Sagredo, V Sanchez-Miralles, A Chinesta, SS Roche-Campo, F Socias, L Sole-Violan, J Suarez-Sipmann, F Lomas, LT Trenado, J Ubeda, A Valdivia, LJ Vidal, P Boado, MV Rodriguez, A Antonelli, M Blasi, F Barbe, F Torres, A |
| author |
Galli, F |
| author_facet |
Galli, F Bindo, F Motos, A Fernandez-Barat, L Barbeta, E Gabarrus, A Ceccato, A Bermejo-Martin, JF Ferrer, R Riera, J Penuelas, O Lorente, JA de Gonzalo-Calvo, D Menendez, R Gonzalez, J Misuraca, S Palomeque, A Amaya-Villar, R Anon, JM Marino, AB Barbera, C Barberan, J Ortiz, AB Bustamante-Munguira, E Caballero, J Canton-Bulnes, ML Perez, CC Carbonell, N Catalan-Gonzalez, M de Frutos, R Franco, N Galban, C Lago, AL Gumucio-Sanguino, VD de la Torre, MD Diaz, E Estella, A Curto, EG Garcia-Garmendia, JL Gomez, JM Huerta, A Garcia, RNJ Loza-Vazquez, A Marin-Corral, J Delgado, MCM de la Gandara, AM Varela, IM Messa, JL Albaiceta, GM Nieto, MT Novo, MA Penasco, Y Perez-Garcia, F Pozo-Laderas, JC Ricart, P Sagredo, V Sanchez-Miralles, A Chinesta, SS Roche-Campo, F Socias, L Sole-Violan, J Suarez-Sipmann, F Lomas, LT Trenado, J Ubeda, A Valdivia, LJ Vidal, P Boado, MV Rodriguez, A Antonelli, M Blasi, F Barbe, F Torres, A |
| author_role |
author |
| author2 |
Bindo, F Motos, A Fernandez-Barat, L Barbeta, E Gabarrus, A Ceccato, A Bermejo-Martin, JF Ferrer, R Riera, J Penuelas, O Lorente, JA de Gonzalo-Calvo, D Menendez, R Gonzalez, J Misuraca, S Palomeque, A Amaya-Villar, R Anon, JM Marino, AB Barbera, C Barberan, J Ortiz, AB Bustamante-Munguira, E Caballero, J Canton-Bulnes, ML Perez, CC Carbonell, N Catalan-Gonzalez, M de Frutos, R Franco, N Galban, C Lago, AL Gumucio-Sanguino, VD de la Torre, MD Diaz, E Estella, A Curto, EG Garcia-Garmendia, JL Gomez, JM Huerta, A Garcia, RNJ Loza-Vazquez, A Marin-Corral, J Delgado, MCM de la Gandara, AM Varela, IM Messa, JL Albaiceta, GM Nieto, MT Novo, MA Penasco, Y Perez-Garcia, F Pozo-Laderas, JC Ricart, P Sagredo, V Sanchez-Miralles, A Chinesta, SS Roche-Campo, F Socias, L Sole-Violan, J Suarez-Sipmann, F Lomas, LT Trenado, J Ubeda, A Valdivia, LJ Vidal, P Boado, MV Rodriguez, A Antonelli, M Blasi, F Barbe, F Torres, A |
| author2_role |
author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author |
| dc.subject.none.fl_str_mv |
Procalcitonin C-reactive protein COVID-19 Bacterial coinfection Critically ill Intensive care |
| topic |
Procalcitonin C-reactive protein COVID-19 Bacterial coinfection Critically ill Intensive care |
| description |
PurposeAlthough 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.MethodsWe 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.ResultsBetween 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 & GE; 0.12 ng/mL was associated with higher 90 days mortality.ConclusionOur 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 |
2023 |
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info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
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article |
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publishedVersion |
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https://i3pt.portalinvestigacion.com/publicaciones/3697 https://www.scopus.com/inward/record.uri?eid=2-s2.0-85166022159&doi=10.1007%2fs00134-023-07161-1&partnerID=40&md5=293348230823059c2f73398310602a3d |
| url |
https://i3pt.portalinvestigacion.com/publicaciones/3697 https://www.scopus.com/inward/record.uri?eid=2-s2.0-85166022159&doi=10.1007%2fs00134-023-07161-1&partnerID=40&md5=293348230823059c2f73398310602a3d |
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Inglés |
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Inglés |
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info:eu-repo/semantics/openAccess |
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openAccess |
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SPRINGER |
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SPRINGER |
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INTENSIVE CARE MEDICINE ISSN: 03424642 ISSNe: 14321238 reponame:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí instname:Institut d'Investigació i Innovació Parc Taulí (I3PT) |
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Institut d'Investigació i Innovació Parc Taulí (I3PT) |
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r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí |
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r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí |
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