Searching for a role of procalcitonin determination in COVID-19: a study on a selected cohort of hospitalized patients.
Clin Chem Lab Med
; 59(2): 433-440, 2020 11 19.
Article
in En
| MEDLINE
| ID: mdl-33554505
ABSTRACT
Objectives:
Procalcitonin (PCT) has been proposed for differentiating viral vs. bacterial infections. In COVID-19, some preliminary results have shown that PCT testing could act as a predictor of bacterial co-infection and be a useful marker for assessment of disease severity.Methods:
We studied 83 COVID-19 hospitalized patients in whom PCT was specifically ordered by attending physicians. PCT results were evaluated according to the ability to accurately predict bacterial co-infections and death in comparison with other known biomarkers of infection and with major laboratory predictors of COVID-19 severity.Results:
Thirty-three (39.8%) patients suffered an in-hospital bacterial co-infection and 44 (53.0%) patients died. In predicting bacterial co-infection, PCT showed a relatively low accuracy (area under receiver-operating characteristic [ROC] curve [AUC] 0.757; 95% confidence interval [CI] 0.651-0.845), with a strength for detecting the outcome not significantly different from that of white blood cell count and C-reactive protein (CRP). In predicting patient death, PCT showed an AUC of 0.815 (CI 0.714-0.892), not better than those of other more common laboratory tests, such as blood lymphocyte percentage (AUC 0.874, p=0.19), serum lactate dehydrogenase (AUC 0.860, p=0.47), blood neutrophil count (AUC 0.845, p=0.59), and serum albumin (AUC 0.839, p=0.73).Conclusions:
Procalcitonin (PCT) testing, even when appropriately ordered, did not provide a significant added value in COVID-19 patients when compared with more consolidated biomarkers of infection and poor clinical outcome. The major application of PCT in COVID-19 is its ability, associated with a negative predictive value >90%, to exclude a bacterial co-infection when a rule-out cut-off (<0.25 µg/L) is applied.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Coinfection
/
Procalcitonin
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COVID-19
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Aged
/
Female
/
Humans
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Male
/
Middle aged
Language:
En
Year:
2020
Type:
Article