Procalcitonin levels in COVID-19 patients

Hu, Rui; Han, Chaofei; Pei, Shiyao; Yin, Mingzhu; Chen, Xiang

doi:10.1016/j.ijantimicag.2020.106051

Cited by 225 publications

(169 citation statements)

References 8 publications

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“…8 That is why PCT has been pursued much later after the start of the pandemic than other biomarkers. Today, it seems that PCT is elevated early in those destined to develop severe disease 9 and one hypothesis we have formed is that, interferon-γ responses are likely delayed in early COVID19 disease, especially in those destined to progress to severe disease and this is in keeping with our findings. Lymphocyte and monocyte percentages being low could indicate that the virus might directly infect these cells resulting in their death since they express the coronavirus receptor ACE2.…”

Section: Performance Measuressupporting

confidence: 88%

A biomarker based severity progression indicator for COVID-19: the Kuwait prognosis indicator score

et al. 2020

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Background : COVID-19 is a worldwide pandemic that is mild in most patients but can result in a pneumonia like illness with progression to acute respiratory distress syndrome and death. Predicting the disease severity at time of diagnosis can be helpful in prioritizing hospital admission and resources. Methods: We prospectively recruited 1096 consecutive patients of whom 643 met the inclusion criterion with COVID-19 from Jaber Hospital, a COVID-19 facility in Kuwait, between 24 February and 20 April 2020. The primary endpoint of interest was disease severity defined algorithmically. Predefined risk variables were collected at the time of PCR based diagnosis of the infection. Prognostic model development used 5-fold cross-validated regularized logit regression. The model was externally validated against data from Wuhan, China. Results: There were 643 patients with clinical course data of whom 94 developed severe COVID-19. In the final model, age, CRP, procalcitonin, lymphocyte percentage, monocyte percentages and serum albumin were independent predictors of a more severe illness course. The final prognostic model demonstrated good discrimination, and both discrimination and calibration were confirmed with an external dataset. Conclusion: We developed and validated a simple score calculated at time of diagnosis that can predict patients with severe COVID-19 disease reliably and that has been validated externally.

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Section: Performance Measuressupporting

confidence: 88%

A biomarker based severity progression indicator for COVID-19: the Kuwait prognosis indicator score

et al. 2020

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“…Moreover, bacteria isolated from blood cultures were mostly contaminants, as was found previously [8], and might lead to repeat blood cultures and unnecessary antibiotic use. We advocate to obtain blood cultures only when COVID-19 is suspected not to be the main problem, either clinically [8] or based on aberrantly elevated inflammatory biomarkers, such as PCT [24]. Such a strategy was actually applied by hospital A in the later phase of the epidemic.…”

Section: Discussionmentioning

confidence: 99%

Few bacterial co-infections but frequent empiric antibiotic use in the early phase of hospitalized patients with COVID-19: results from a multicentre retrospective cohort study in The Netherlands

Karami

Knoop

Dofferhoff

et al. 2020

Infectious Diseases

126

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“…This apparent controversy in the accuracy of NMR to discriminate patients at higher risk of death might be explained by understanding the impact of ethnicity on the development and clinical presentation of Covid-19. In this sense, several groups mostly from China have proposed that the serum levels of D-dimer, ferritin, CRP, troponin I, LDH, and procalcitonin are good predictors of mortality in patients with severe Covid-19 [ 8 , 9 , 13 ]. However, our study shows that in Mexican patients these biochemical and immune parameters exhibit poorer ability to predict mortality than that found for LNR and NMR.…”

Section: Discussionmentioning

confidence: 99%

“…Clinical features of patients with Covid-19 have revealed a number of potential biochemical markers associated with in-hospital mortality. In particular, the blood levels of D-dimer, ferritin, C-reactive protein (CRP), troponin I, lactate dehydrogenase (LDH), and procalcitonin have been extensively studied due to their apparently good accuracy to discriminate patients with the most severe courses of the disease [ 8 , 9 , 10 , 11 , 12 , 13 ]. In parallel, numerous studies have also proposed the use of hematological markers such as lymphocyte, monocyte, and neutrophil counts that seem to associate with increased severity and mortality in patients with Covid-19 [ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

The Neutrophil-to-Monocyte Ratio and Lymphocyte-to-Neutrophil Ratio at Admission Predict In-Hospital Mortality in Mexican Patients with Severe SARS-CoV-2 Infection (Covid-19)

et al. 2020

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There is a deep need for mortality predictors that allow clinicians to quickly triage patients with severe coronavirus disease 2019 (Covid-19) into intensive care units at the time of hospital admission. Thus, we examined the efficacy of the lymphocyte-to-neutrophil ratio (LNR) and neutrophil-to-monocyte ratio (NMR) as predictors of in-hospital death at admission in patients with severe Covid-19. A total of 54 Mexican adult patients with Covid-19 that met hospitalization criteria were retrospectively enrolled, followed-up daily until hospital discharge or death, and then assigned to survival or non-survival groups. Clinical, demographic, and laboratory parameters were recorded at admission. A total of 20 patients with severe Covid-19 died, and 75% of them were men older than 62.90 ± 14.18 years on average. Type 2 diabetes, hypertension, and coronary heart disease were more prevalent in non-survivors. As compared to survivors, LNR was significantly fourfold decreased while NMR was twofold increased. LNR ≤ 0.088 predicted in-hospital mortality with a sensitivity of 85.00% and a specificity of 74.19%. NMR ≥ 17.75 was a better independent risk factor for mortality with a sensitivity of 89.47% and a specificity of 80.00%. This study demonstrates for the first time that NMR and LNR are accurate predictors of in-hospital mortality at admission in patients with severe Covid-19.

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Procalcitonin levels in COVID-19 patients

Cited by 225 publications

References 8 publications

A biomarker based severity progression indicator for COVID-19: the Kuwait prognosis indicator score

A biomarker based severity progression indicator for COVID-19: the Kuwait prognosis indicator score

Few bacterial co-infections but frequent empiric antibiotic use in the early phase of hospitalized patients with COVID-19: results from a multicentre retrospective cohort study in The Netherlands

The Neutrophil-to-Monocyte Ratio and Lymphocyte-to-Neutrophil Ratio at Admission Predict In-Hospital Mortality in Mexican Patients with Severe SARS-CoV-2 Infection (Covid-19)

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