Evaluation of serum procalcitonin level as a biomarker for disease severity in COVID-19 patients

Waris, Abdul; Din, Misbahud; Iqbal, Nouman; Yar, Lubna; Khalid, Atiqa; Nawaz, Mehboob; Baset, Abdul; Ali, Muhammad

doi:10.1016/j.nmni.2021.100922

Cited by 8 publications

(5 citation statements)

References 24 publications

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“…Patients with severe COVID-19 are highly susceptible to superimposed bacterial, fungal, and viral infections, including ventilator-associated pneumonia and bloodstream infection, among others ( 29 , 30 ). As for systemic biomarkers of infection, procalcitonin is a predictor of disease severity ( 31 ), and can be useful to guide antimicrobial stewardship ( 32 , 33 ). Another study found an association between procalcitonin and mortality in COVID-19 patients more than 75 years old ( 34 ).…”

Section: Diagnostic and Prognostic Value Of Biomarkersmentioning

confidence: 99%

Laboratory Biomarkers for Diagnosis and Prognosis in COVID-19

et al. 2022

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Severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) causes a wide spectrum of clinical manifestations, with progression to multiorgan failure in the most severe cases. Several biomarkers can be altered in coronavirus disease 2019 (COVID-19), and they can be associated with diagnosis, prognosis, and outcomes. The most used biomarkers in COVID-19 include several proinflammatory cytokines, neuron-specific enolase (NSE), lactate dehydrogenase (LDH), aspartate transaminase (AST), neutrophil count, neutrophils-to-lymphocytes ratio, troponins, creatine kinase (MB), myoglobin, D-dimer, brain natriuretic peptide (BNP), and its N-terminal pro-hormone (NT-proBNP). Some of these biomarkers can be readily used to predict disease severity, hospitalization, intensive care unit (ICU) admission, and mortality, while others, such as metabolomic and proteomic analysis, have not yet translated to clinical practice. This narrative review aims to identify laboratory biomarkers that have shown significant diagnostic and prognostic value for risk stratification in COVID-19 and discuss the possible clinical application of novel analytic strategies, like metabolomics and proteomics. Future research should focus on identifying a limited but essential number of laboratory biomarkers to easily predict prognosis and outcome in severe COVID-19.

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Section: Diagnostic and Prognostic Value Of Biomarkersmentioning

confidence: 99%

Laboratory Biomarkers for Diagnosis and Prognosis in COVID-19

et al. 2022

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“… Heesom et al 21 0.5 ng/mL Procalcitonin can be used as an Antibiotic Stewardship tool to de-escalate the use of antibiotics. Waris et al 14 0.25 ng/mL Procalcitonin (>0.25) is an indicator of bacterial coinfection in COVID-19 patients. Hughes et al 15 0.25 ng/mL 1- Procalcitonin (>0.25) is an indicator of bacterial coinfection in COVID-19 patients.…”

Section: Resultsmentioning

confidence: 99%

Procalcitonin as a Tool to Antimicrobial Stewardship in COVID-19 Patients with Superimposed Bacterial Infections: A Systematic Review

Omer¹,

Abuthiyab²,

Zaid³

et al. 2022

JIR

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Procalcitonin is an inflammatory marker that had shown marked potential as an antimicrobial stewardship tool for administering antibiotics when needed in patients with pneumonia as it raises concurrently with other inflammatory markers, yet no systematic review has assessed its potential in COVID-19 patients. This systematic review aimed to assess the potential appropriateness of procalcitonin as an antimicrobial stewardship tool in COVID-19 patients with superimposed bacterial and non-bacterial infections. All study designs published after 2019 were included in this systematic review. We included all studies that had reported procalcitonin levels in COVID-19 patients with suspected superimposed secondary infection(s). We searched MEDLINE, Scopus, and the Directory for Open Access Journal from April 2022 to May 2022 and retrieved all related articles for screening with no restrictions on language. We conducted risk of bias assessment according to the Critical Appraisal Skills Programme (CASP) criteria for cohort and case-control studies. Results were presented according to procalcitonin cut-off values, gold standard test used to confirm infection, and overall study conclusion(s), among other variables. This systematic review included 18 articles with 7196 patients in 8 countries. Despite different cut-off values of procalcitonin used, thirteen studies had indicated the appropriateness of using procalcitonin as antimicrobial stewardship tool in COVID-19 patients. We urge physicians to take this into account when treating COVID-19 patients suspected of superimposed infections and we look forward to further studies with standardized procalcitonin cut-off values that may provide appropriate quantitative data that can contribute to clinical guidelines. Registration (PROSPERO): CRD42022315013.

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“…Procalcitonin (PCT), a precursor of the hormone calcitonin, is an important inflammatory biomarker that is synthesized mainly in response to bacterial infections, reflecting the extent of the systemic inflammatory response. Bacterial toxins are crucial in the induction of the synthesis of this protein, which is also stimulated by high levels of tumor necrosis factor (TNF-α) and interleukin-6 (IL-6), produced in response to infection [ 29 ]. Procalcitonin is considered a useful diagnostic marker, allowing to distinguish bacterial infection from viral infection and as a prognostic determinant of the severity of infection and effectiveness of applied antibiotic therapy [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 Pandemic on the Epidemiology of Bloodstream Infections in Hospitalized Patients—Experience from a 4th Military Clinical Hospital in Poland

Słabisz,

Dudek-Wicher,

Leśnik

et al. 2023

JCM

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Bloodstream infections (BSIs) are associated with high mortality and inappropriate or delayed antimicrobial therapy. The purpose of this study was to investigate the impact of the COVID-19 pandemic on the epidemiology of BSIs in hospitalized patients. The research aimed to compare the incidence of BSIs and blood culture results in patients hospitalized before and during the COVID-19 pandemic. Methods: Retrospective and prospective data were collected from blood cultures obtained from 4289 patients hospitalized between June 2018 and July 2022. Two groups of patients were distinguished: those with BSIs admitted during the pre-COVID-19 period and those admitted during the COVID-19 surge. Demographic and clinical data, blood cytology, and biochemistry results were analyzed, and the usefulness of PCT was assessed in patients with COVID-19. Results: The study showed a significant increase in the incidence of BSIs during the pandemic compared to the pre-COVID-19 period. Positive blood cultures were obtained in 20% of patients hospitalized during the pandemic (vs. 16% in the pre-COVID-19 period). The incidence of BSIs increased from 1.13 to 2.05 cases per 1000 patient days during COVID-19, and blood culture contamination was more frequently observed. The mortality rate was higher for patients hospitalized during the COVID-19 pandemic. An increased frequency of MDRO isolation was observed in the COVID-19 period. Conclusions: The incidence of BSIs increased and the mortality rate was higher in the COVID-19 period compared to the pre-COVID-19 period. The study showed limited usefulness of procalcitonin in patients with COVID-19, likely due to the administered immunosuppressive therapy.

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Evaluation of serum procalcitonin level as a biomarker for disease severity in COVID-19 patients

Cited by 8 publications

References 24 publications

Laboratory Biomarkers for Diagnosis and Prognosis in COVID-19

Laboratory Biomarkers for Diagnosis and Prognosis in COVID-19

Procalcitonin as a Tool to Antimicrobial Stewardship in COVID-19 Patients with Superimposed Bacterial Infections: A Systematic Review

Impact of the COVID-19 Pandemic on the Epidemiology of Bloodstream Infections in Hospitalized Patients—Experience from a 4th Military Clinical Hospital in Poland

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