Procalcitonin as Biomarker of Infection: Implications for Evaluation and Treatment

Gonçalves, Pedro Falcão; Falcão, Luiz Menezes; Pinheiro, Isabel

doi:10.1097/mjt.0000000000000210

Cited by 15 publications

(5 citation statements)

References 37 publications

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“…Its release is mediated by proinflammatory cytokines, such as tumor necrosis factor-alpha and interleukin-6. [13]. Studies found that PCT levels were lower in seriously ill patients with viral infections and were much higher in bacterial infections [14].…”

Section: Introductionmentioning

confidence: 99%

Poor Prognostic Biochemical Markers Predicting Fatalities Caused by COVID-19: A Retrospective Observational Study From a Developing Country

Asghar¹,

Kazmi²,

Khan³

et al. 2020

Cureus

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Background and objectives Infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are rapidly spreading, posing a serious threat to the health of people worldwide, resulting in the World Health Organization officially declaring it a pandemic. There are several biochemical markers linked with predicting the severity of coronavirus disease. This study aims to identify the most effective predictive biomarker such as C-reactive protein (CRP), ferritin, lactate dehydrogenase (LDH), procalcitonin (PCT), and D-dimer, among others, in predicting the clinical outcome of the disease. Materials and methods This study was conducted as a retrospective, observational, multi-centric study, including all admitted COVID-19 positive patients only. The disease outcome was followed along with the hospital course of every patient at the time of analysis. Baseline laboratory investigations of all patients were monitored both at admission and discharge. A comparative analysis was done between the survivors (n=263) and non-survivors (n=101). Statistical analysis was conducted using IBM SPSS Statistics for Windows Version 25 (Armonk, NY: IBM Corp.). Results Of 364 patients, 65.7% were in the isolation ward, and 34.3% were in the intensive care unit; 72.3% of patients survived, while 27.7% of patients died. The mean age of the study population was 52.6 ± 15.8 years with female patients significantly younger than male patients (p=0.001) and 50 to 75 years being the most common age group (p=0.121). Among the survivors versus non-survivors of COVID-19, there were significant differences in total leukocyte count (p<0.001), neutrophil count, (p<0.001), lymphocyte count (p<0.001), urea (p<0.001), serum bicarbonate (p=0.001), CRP levels (p<0.001), LDH (p=0.013), and D-dimer (p<0.001) at admission. At discharge, the laboratory values of non-surviving patients showed significant leukocytosis (p<0.001), neutrophilia (p<0.001), lymphocytopenia (p<0.001), decreased monocytes (p<0.001), elevated urea and creatinine (p<0.001), hypernatremia (p<0.001), decreased serum bicarbonate levels (p<0.001), elevated CRP level (p=0.040), LDH (p<0.001), 1 2 3 4 4 4 5

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Section: Introductionmentioning

confidence: 99%

Poor Prognostic Biochemical Markers Predicting Fatalities Caused by COVID-19: A Retrospective Observational Study From a Developing Country

Asghar¹,

Kazmi²,

Khan³

et al. 2020

Cureus

View full text Add to dashboard Cite

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“…While under normal conditions, PCT is produced exclusively by the thyroid gland, when challenged with infection, a significant production of PCT by nonthyroidal tissues occurs [ 35 ]. The release of PCT is mediated by proinflammatory cytokines, such as tumor necrosis factor-alpha and interleukin-6 [ 39 ]. Procalcitonin is widely considered to be the useful marker of severe systemic inflammation because of its valuable role in the diagnosis and prognosis in regards to sepsis [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

“Predictors of in-hospital mortality in adult cancer patients with COVID-19 infection presenting to the emergency department: A retrospective study”

Zahran

Kalot²,

Khalifeh³

et al. 2023

PLoS ONE

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Background Adult cancer patients are at higher risk of morbidity and mortality following COVID-19 infection. Being on the front lines, it is crucial for emergency physicians to identify those who are at higher risk of mortality. The aim of our study was to determine the predictors of in-hospital mortality in COVID-19 positive cancer patients who present to the emergency department. Methods This is a retrospective cohort study conducted on adult cancer patients who presented to the ED of the American university of Beirut medical center from February 21, 2020, till February 21, 2021, and were found to have COVID-19 infection. Relevant data was extracted and analyzed. The association between different variables and in-hospital mortality was tested using Student’s t test and Fisher’s exact test or Pearson’s Chi-square where appropriate. Logistic regression was applied to factors with p <0.2 in the univariate models. Results The study included 89 distinct patients with an average age of 66 years (± 13.6). More than half of them were smokers (52.8%) and had received chemotherapy within 1 month of presentation (52.8%). About one third of the patients died (n = 31, 34.8%). Mortality was significantly higher in patients who had recently received chemotherapy (67.7% vs 44.8%, p = .039), a history of congestive heart failure (CHF)(p = .04), higher levels of CRP (p = 0.048) and/or PCT(p<0.04) or were tachypneic in the ED (P = 0.016). Conclusions Adult cancer patients with COVID-19 infection are at higher risks of mortality if they presented with tachypnea, had a recent chemotherapy, history of CHF, high CRP, and high procalcitonin levels at presentation.

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“…Previous studies demonstrated CRP lack specificity for sepsis due to an increase in non-infectious inflammatory conditions [ 33 ]. The levels of PCT could help to guide the antibiotic therapy in patients with sepsis, while the heterogeneous data of PCT failed to provide guidance for the benefits of sepsis patients [ 34 , 35 ]. Current literature suggested miRNAs played a vital role in the pathophysiology of sepsis and could distinguish the various phases of sepsis [ 6 – 9 , 11 , 14 – 31 ].…”

Section: Discussionmentioning

confidence: 99%

Accuracy of circulating microRNAs in diagnosis of sepsis: a systematic review and meta-analysis

et al. 2020

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Objectives The aim of this study was to systematically assess the accuracy of circulating microRNAs (miRNAs) as a promising biomarker for sepsis via a meta-analysis. Methods PubMed, Cochrane Library, Embase, Web of Science, Scopus, and Ovid databases were searched up to April 3, 2020. The Quality in Prognostic Studies (QUADAS-2) tool was used to assess methodological quality. The pooled sensitivity (Sen), specificity (Spe), positive or negative likelihood ratios (PLR or NLR), diagnostic odds ratio (DOR), curve, and area under the curve (AUC) were calculated with 95% confidence interval (95% CI). The overall accuracy (OA) of miRNAs, procalcitonin (PCT), and C-reactive protein (CRP) was analyzed by the chi-square test. Results A total of 22 records were eligible for systematic review, including 2210 sepsis, 426 systemic inflammatory response syndrome (SIRS), and 1076 healthy controls (HC). The pooled Sen, Spe, and DOR of miRNAs were 0.80 (95% CI 0.75–0.83), 0.85 (95% CI 0.80–0.89), and 22 (15–32), respectively. The DOR of PCT and CRP were 17 (95% CI 4–68) and 7 (95% CI 1–48), respectively. The OA value of miRNAs (79.02%) and PCT (76.95%) were higher than CRP (61.22%) (P < 0.000). The subgroup analysis indicated that miRNAs in adults, serum type, downregulation of miRNA expression, criteria of Sepsis-3, internal reference of non-U6, and dysregulation expression of miR-223 had superior diagnostic accuracy. In addition, there was no significant publication bias among the included studies. Fagan’s nomogram showed valuable clinical utility. Conclusions Our meta-analysis indicated that the level of circulating miRNAs, particularly the miR-223, could be used as an indicator for sepsis.

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Procalcitonin as Biomarker of Infection: Implications for Evaluation and Treatment

Cited by 15 publications

References 37 publications

Poor Prognostic Biochemical Markers Predicting Fatalities Caused by COVID-19: A Retrospective Observational Study From a Developing Country

Poor Prognostic Biochemical Markers Predicting Fatalities Caused by COVID-19: A Retrospective Observational Study From a Developing Country

“Predictors of in-hospital mortality in adult cancer patients with COVID-19 infection presenting to the emergency department: A retrospective study”

Accuracy of circulating microRNAs in diagnosis of sepsis: a systematic review and meta-analysis

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