High procalcitonin levels associated with increased intensive care unit admission and mortality in patients with a COVID-19 infection in the emergency department

Tong‐Minh, Kirby; Does, Yuri van der; Engelen, Susanna; Jong, Evelien de; Ramakers, Christian; Gommers, Diederik; Gorp, Eric C. M. Van; Endeman, Henrik

doi:10.1186/s12879-022-07144-5

Cited by 48 publications

(47 citation statements)

References 30 publications

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“…It was an independent risk factor for ICU admission (OR: 1.492, 95% CI: 1.031-2.160) in the multivariate analysis. Similar to our study, Tong-Minh et al (24) showed correlation between procalcitonin levels and mortality and procalcitonin was an independent risk factor for mortality (OR: 2.11, 95% CI: 1.36-3.61) in multivariate analysis.…”

Section: Discussionsupporting

confidence: 91%

The Role of Inflammatory Parameters in the Prognosis of Patients with COVID-19

Canoğlu¹,

Çalışkan²,

Sinmez³

et al. 2022

hamidiyemedj

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Background:The prognostic significance of inflammatory parameters in patients with Coronavirus disease-2019 (COVID-19) has been investigated. Materials and Methods:Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio, C-reactive protein (CRP) albumin ratio (CAR), systemic inflammation index (SII), CRP-lymphocyte ratio (CRP/L), neutrophil to lymphocyte, platelet ratio (NLPR), red cell volume distribution width index (RDW-SD), and procalcitonin were evaluated in relation to admission to intensive care unit (ICU) and mortality in 419 patients with moderate-to-severe COVID-19.Results: NLR, CAR, CRP/L, NLPR, RDW-SD and procalcitonin levels were higher both in those who needed ICU compared to those who did not (p=0.001, 0.005, 0.002, 0.001, 0.001 and 0.001; respectively), and in those who died compared to the survival group (p=0.001, 0.024, 0.009, 0.001, 0.001 and 0.001; respectively). SII was higher only in those who needed ICU (p=0.001). NLR (0.610, p=0.002), CAR (0.602, p=0.005), SII (0.573, p=0.043), CRP/L (0.593, p=0.010), and NLPR (0.618, p=0.001) were statistically significant for admission to ICU; and NLR (0.637, p=0.006), CAR (0.613, p=0.024), CRP/L (0.605, p=0.035) and NLPR (0.660, p=0.001) were statistically significant for mortality in the evaluation of area under curve in ROC analysis. RDW-SD was an independent risk factor for both ICU admission [odds ratio (OR): 1.194, p=0.024] and mortality (OR: 1.263, p=0.002), and procalcitonin was an independent risk factor for ICU admission (OR: 1.492, p=0.034) in multivariate analysis. Conclusion:NLR, CAR, CRP/L, NLPR, RDW-SD and procalcitonin were determined as prognostic parameters in terms of both the need for ICU and mortality in patients with COVID-19. SII was a prognostic parameter only for the need for ICU.

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Section: Discussionsupporting

confidence: 91%

The Role of Inflammatory Parameters in the Prognosis of Patients with COVID-19

Canoğlu¹,

Çalışkan²,

Sinmez³

et al. 2022

hamidiyemedj

View full text Add to dashboard Cite

show abstract

“…Some studies have shown that some routine clinical laboratory tests, such as lymphocyte count, lactate dehydrogenase and D-dimer are known to be affected in patients with COVID-19 (20), with lymphopenia, raised lactate dehydrogenase and elevated D-dimer being associated with worse disease severity and outcomes (21-23). Other studies have shown significant differences in inflammatory markers amongst patients who required ICU admission compared to patients who have not, and markers of infection and inflammation such as C-reactive protein, procalcitonin, and ferritin which are, as expected, correlated with severe disease (24)(25)(26)(27).…”

Section: Discussionsupporting

confidence: 67%

Assessment of background levels of autoantibodies as a prognostic marker for severe SARS-CoV-2 infection

et al. 2022

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Background: Patients with more severe forms of SARS-CoV-2 exhibit activation of immunological cascades. Participants (current or ex-smokers with at least 20 years pack history) in a trial (Early Diagnosis of Lung Cancer, Scotland [ECLS]) of autoantibody detection to predict lung cancer risk had seven autoantibodies measured 5 years before the pandemic. This study compared the response to Covid infection in study participants who tested positive and negative to antibodies to tumour-associated antigens: p53, NY-ESO-1, CAGE, GBU4-5, HuD, MAGE A4 and SOX2. Methods: Autoantibody data from the ECLS study was deterministically linked to the EAVE II database, a national, real-time prospective cohort using Scotland’s health data infrastructure, to describe the epidemiology of SARS-CoV-2 infection, patterns of healthcare use and outcomes. The strength of associations was explored using a network algorithm for exact contingency table significance testing by permutation. Results: There were no significant differences discerned between SARS-CoV-2 test results and EarlyCDT-Lung test results (p = 0.734). An additional analysis of intensive care unit (ICU) admissions detected no significant differences between those who tested positive and negative. Subgroup analyses showed no difference in COVID-19 positivity or death rates amongst those diagnosed with chronic obstructive pulmonary disease (COPD) with positive and negative EarlyCDT results. Conclusions: This hypothesis-generating study demonstrated no clinically valuable or statistically significant associations between EarlyCDT positivity in 2013-15 and the likelihood of SARS-CoV-2 positivity in 2020, ICU admission or death in all participants (current or ex-smokers with at least 20 years pack history) or in those with COPD or lung cancer.

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“…However, since treatments used for COVID-19 can alter the classical inflammation markers, detecting a bacterial infection in the earlier phase of the pandemic was more difficult [ 6 ]. In addition, COVID-19 itself increases C-reactive protein (CRP) and procalcitonin values—markers for bacterial infection, whose values are associated with disease severity [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Antibiotic Prescription and In-Hospital Mortality in COVID-19: A Prospective Multicentre Cohort Study

Pinte

Ceasovschih

Niculae

et al. 2022

JPM

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Background: Since the beginning of the COVID-19 pandemic, empiric antibiotics (ATBs) have been prescribed on a large scale in both in- and outpatients. We aimed to assess the impact of antibiotic treatment on the outcomes of hospitalised patients with moderate and severe coronavirus disease 2019 (COVID-19). Methods: We conducted a prospective multicentre cohort study in six clinical hospitals, between January 2021 and May 2021. Results: We included 553 hospitalised COVID-19 patients, of whom 58% (311/553) were prescribed antibiotics, while bacteriological tests were performed in 57% (178/311) of them. Death was the outcome in 48 patients—39 from the ATBs group and 9 from the non-ATBs group. The patients who received antibiotics during hospitalisation had a higher mortality (RR = 3.37, CI 95%: 1.7–6.8), and this association was stronger in the subgroup of patients without reasons for antimicrobial treatment (RR = 6.1, CI 95%: 1.9–19.1), while in the subgroup with reasons for antimicrobial therapy the association was not statistically significant (OR = 2.33, CI 95%: 0.76–7.17). After adjusting for the confounders, receiving antibiotics remained associated with a higher mortality only in the subgroup of patients without criteria for antibiotic prescription (OR = 10.3, CI 95%: 2–52). Conclusions: In our study, antibiotic treatment did not decrease the risk of death in the patients with mild and severe COVID-19, but was associated with a higher risk of death in the subgroup of patients without reasons for it.

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High procalcitonin levels associated with increased intensive care unit admission and mortality in patients with a COVID-19 infection in the emergency department

Cited by 48 publications

References 30 publications

The Role of Inflammatory Parameters in the Prognosis of Patients with COVID-19

The Role of Inflammatory Parameters in the Prognosis of Patients with COVID-19

Assessment of background levels of autoantibodies as a prognostic marker for severe SARS-CoV-2 infection

Antibiotic Prescription and In-Hospital Mortality in COVID-19: A Prospective Multicentre Cohort Study

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