Initial Inflammatory Profile in Community-acquired Pneumonia Depends on Time since Onset of Symptoms

Méndez, Raúl; Menéndez, Rosário; Cillóniz, Catia; Amara-Elori, Isabel; Amaro, Rosanel; González, Paula; Posadas, Tomás; Gimeno, Alexandra; España, Pedro Pablo; Almirall, Jordi; Torres, Antoni

doi:10.1164/rccm.201709-1908oc

Cited by 46 publications

(37 citation statements)

References 42 publications

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“…A study looked at 541 patients who presented to the emergency department with CAP and were differentiated into early presenters (< 3 d since onset of symptoms) and late presenters (> 3 d). Results showed that CRP and PCT were lower in patients who were early presenters suggesting that time to presentation may affect the interpretation of these biomarkers [28] .…”

Section: Pctmentioning

confidence: 99%

Diagnosis and treatment of acute pulmonary inflammation in critically ill patients: The role of inflammatory biomarkers

Chalmers¹,

Khawaja²,

Wieruszewski³

et al. 2019

WJCCM

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Pneumonia and acute respiratory distress syndrome are common and important causes of respiratory failure in the intensive care unit with a significant impact on morbidity, mortality and health care utilization despite early antimicrobial therapy and lung protective mechanical ventilation. Both clinical entities are characterized by acute pulmonary inflammation in response to direct or indirect lung injury. Adjunct anti-inflammatory treatment with corticosteroids is increasingly used, although the evidence for benefit is limited. The treatment decisions are based on radiographic, clinical and physiological variables without regards to inflammatory state. Current evidence suggests a role of biomarkers for the assessment of severity, and distinguishing sub-phenotypes (hyperinflammatory versus hypo-inflammatory) with important prognostic and therapeutic implications. Although many inflammatory biomarkers have been studied the most common and of interest are C-reactive protein, procalcitonin, and pro-inflammatory cytokines including interleukin 6. While extensively studied as prognostic tools (prognostic enrichment), limited data are available for the role of biomarkers in determining appropriate initiation, timing and dosing of adjunct anti-inflammatory treatment (predictive enrichment)

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Section: Pctmentioning

confidence: 99%

Diagnosis and treatment of acute pulmonary inflammation in critically ill patients: The role of inflammatory biomarkers

Chalmers¹,

Khawaja²,

Wieruszewski³

et al. 2019

WJCCM

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“…Factors, such as the time elapsed since the onset of symptoms, influence CRP kinetics. CPR is more useful in evaluating the inflammatory response of patients at three or more days since the onset of symptoms, because, within the first 48 h, their levels are still raising [116]. Finally, CRP may be useful for cardiovascular risk assessment in healthy women [117].…”

Section: C-reactive Proteinmentioning

confidence: 99%

“…Interferon gamma, a molecule synthesized in the inflammatory immune response against viral infection, inhibits its synthesis, and therefore their levels are low in these infections. Due to its rapid kinetic in CAP patients within the first 48 h since the onset of CAP symptoms, PCT levels are more useful than CRP that is still mounting [116].…”

Section: Procalcitoninmentioning

confidence: 99%

Biomarkers in Community-Acquired Pneumonia (Cardiac and Non-Cardiac)

Méndez

Aldás

Menéndez

2020

JCM

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Community-acquired pneumonia (CAP) remains the first cause of morbidity and mortality worldwide due to infection. Several aspects such as severity and host response are related to its clinical course and outcome. Beyond the acute implications that the infection provokes in the host, pneumonia also has long-term negative consequences. Among them, cardiovascular complications and mortality are the most outstanding. Therefore, an adequate recognition and stratification of the risk of complications and mortality is crucial. Many biomarkers have been studied for these reasons, considering that each biomarker mirrors a different aspect. Moreover, the clinical application of many of them is still being deliberated because of their limitations and the heterogeneity of the disease. In this review, we examine some of the most relevant biomarkers that we have classified as cardiac and non-cardiac. We discuss some classic biomarkers and others that are considered novel biomarkers, which are mainly involved in cardiovascular risk.

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“…Given its widespread availability, it has been validated as a point-of-care (POC) lab test to guide antibiotic use in primary care [54], and levels have been correlated to disease severity and complications in community-acquired pneumonia [55]. Used with other inflammatory marker profiles, CRP may be used to pinpoint the time of infection: In patients who present within 3 days of disease onset, CRP was low, but in patients who present after more than 3 days of symptom onset, CRP levels rose significantly [56].…”

Section: C-reactive Proteinmentioning

confidence: 99%

Molecular Diagnostics in Pulmonary Infections

Gao

Huston

Toro

et al. 2020

Precision in Pulmonary, Critical Care, and Sleep Medicine

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Initial Inflammatory Profile in Community-acquired Pneumonia Depends on Time since Onset of Symptoms

Abstract: Time since symptom onset modifies the systemic inflammatory profile at CAP diagnosis. This information has relevant clinical implications for management, and it should be taken into account in the design of future clinical trials.

Cited by 46 publications

References 42 publications

Diagnosis and treatment of acute pulmonary inflammation in critically ill patients: The role of inflammatory biomarkers

Diagnosis and treatment of acute pulmonary inflammation in critically ill patients: The role of inflammatory biomarkers

Biomarkers in Community-Acquired Pneumonia (Cardiac and Non-Cardiac)

Molecular Diagnostics in Pulmonary Infections

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