Biomarkers for differentiation of coronavirus disease 2019 or extracorporeal membrane oxygenation related inflammation and bacterial/fungal infections in critically ill patients: A prospective observational study
Secondary infections in coronavirus disease 2019 (COVID-19) patients are difficult to distinguish from inflammation associated with COVID-19 and/or extracorporeal membrane oxygenation (ECMO). Therefore, highly specific and sensitive biomarkers are needed to identify patients in whom antimicrobial th...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-10-01
|
| Series: | Frontiers in Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2022.917606/full |
| _version_ | 1817982156923731968 |
|---|---|
| author | Matthias Weiss-Tessbach Matthias Weiss-Tessbach Franz Ratzinger Markus Obermueller Heinz Burgmann Thomas Staudinger Oliver Robak Monika Schmid Bernhard Roessler Bernd Jilma Manuel Kussmann Ludwig Traby |
| author_facet | Matthias Weiss-Tessbach Matthias Weiss-Tessbach Franz Ratzinger Markus Obermueller Heinz Burgmann Thomas Staudinger Oliver Robak Monika Schmid Bernhard Roessler Bernd Jilma Manuel Kussmann Ludwig Traby |
| author_sort | Matthias Weiss-Tessbach |
| collection | DOAJ |
| description | Secondary infections in coronavirus disease 2019 (COVID-19) patients are difficult to distinguish from inflammation associated with COVID-19 and/or extracorporeal membrane oxygenation (ECMO). Therefore, highly specific and sensitive biomarkers are needed to identify patients in whom antimicrobial therapy can be safely withheld. In this prospective monocentric study, 66 COVID-19 patients admitted to the intensive care unit (ICU) for ECMO evaluation were included. A total of 46 (70%) patients with secondary infections were identified by using broad microbiological and virological panels and standardized diagnostic criteria. Various laboratory parameters including C-reactive protein (CRP), interleukin (IL)-6, procalcitonin (PCT), and IL-10 were determined at time of study inclusion. The best test performance for differentiating bacterial/fungal secondary infections and COVID-19 and/or ECMO associated inflammation was achieved by IL-10 (ROC-AUC 0.84) and a multivariant step-wise regression model including CRP, IL-6, PCT, and IL-10 (ROC-AUC 0.93). Data obtained in the present study highlights the use of IL-10 to differentiate secondary bacterial/fungal infections from COVID-19 and/or ECMO associated inflammation in severely ill COVID-19 patients. |
| first_indexed | 2024-04-13T23:15:55Z |
| format | Article |
| id | doaj.art-15194d9722af4576b4c7821c107a7671 |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-04-13T23:15:55Z |
| publishDate | 2022-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-15194d9722af4576b4c7821c107a76712022-12-22T02:25:23ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-10-01910.3389/fmed.2022.917606917606Biomarkers for differentiation of coronavirus disease 2019 or extracorporeal membrane oxygenation related inflammation and bacterial/fungal infections in critically ill patients: A prospective observational studyMatthias Weiss-Tessbach0Matthias Weiss-Tessbach1Franz Ratzinger2Markus Obermueller3Heinz Burgmann4Thomas Staudinger5Oliver Robak6Monika Schmid7Bernhard Roessler8Bernd Jilma9Manuel Kussmann10Ludwig Traby11Division of Infectious Diseases and Tropical Medicine, Department of Medicine I, Medical University of Vienna, Vienna, AustriaDepartment of Clinical Pharmacology, Medical University of Vienna, Vienna, AustriaIhr Labor, Medical Diagnostics Laboratories, Vienna, AustriaDivision of Infectious Diseases and Tropical Medicine, Department of Medicine I, Medical University of Vienna, Vienna, AustriaDivision of Infectious Diseases and Tropical Medicine, Department of Medicine I, Medical University of Vienna, Vienna, AustriaDepartment of Medicine I, Intensive Care Unit 13i2, Medical University of Vienna, Vienna, AustriaDepartment of Medicine I, Intensive Care Unit 13i2, Medical University of Vienna, Vienna, AustriaDivision of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna, AustriaDepartment of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical Simulation and Emergency Management Research Group, Medical University of Vienna, Vienna, AustriaDepartment of Clinical Pharmacology, Medical University of Vienna, Vienna, AustriaDivision of Infectious Diseases and Tropical Medicine, Department of Medicine I, Medical University of Vienna, Vienna, AustriaDivision of Infectious Diseases and Tropical Medicine, Department of Medicine I, Medical University of Vienna, Vienna, AustriaSecondary infections in coronavirus disease 2019 (COVID-19) patients are difficult to distinguish from inflammation associated with COVID-19 and/or extracorporeal membrane oxygenation (ECMO). Therefore, highly specific and sensitive biomarkers are needed to identify patients in whom antimicrobial therapy can be safely withheld. In this prospective monocentric study, 66 COVID-19 patients admitted to the intensive care unit (ICU) for ECMO evaluation were included. A total of 46 (70%) patients with secondary infections were identified by using broad microbiological and virological panels and standardized diagnostic criteria. Various laboratory parameters including C-reactive protein (CRP), interleukin (IL)-6, procalcitonin (PCT), and IL-10 were determined at time of study inclusion. The best test performance for differentiating bacterial/fungal secondary infections and COVID-19 and/or ECMO associated inflammation was achieved by IL-10 (ROC-AUC 0.84) and a multivariant step-wise regression model including CRP, IL-6, PCT, and IL-10 (ROC-AUC 0.93). Data obtained in the present study highlights the use of IL-10 to differentiate secondary bacterial/fungal infections from COVID-19 and/or ECMO associated inflammation in severely ill COVID-19 patients.https://www.frontiersin.org/articles/10.3389/fmed.2022.917606/fulldiagnosis differentialspecificity and sensitivityco-infectioninterleukin-10intensive care unitextracorporeal membrane oxygenation (ECMO) |
| spellingShingle | Matthias Weiss-Tessbach Matthias Weiss-Tessbach Franz Ratzinger Markus Obermueller Heinz Burgmann Thomas Staudinger Oliver Robak Monika Schmid Bernhard Roessler Bernd Jilma Manuel Kussmann Ludwig Traby Biomarkers for differentiation of coronavirus disease 2019 or extracorporeal membrane oxygenation related inflammation and bacterial/fungal infections in critically ill patients: A prospective observational study Frontiers in Medicine diagnosis differential specificity and sensitivity co-infection interleukin-10 intensive care unit extracorporeal membrane oxygenation (ECMO) |
| title | Biomarkers for differentiation of coronavirus disease 2019 or extracorporeal membrane oxygenation related inflammation and bacterial/fungal infections in critically ill patients: A prospective observational study |
| title_full | Biomarkers for differentiation of coronavirus disease 2019 or extracorporeal membrane oxygenation related inflammation and bacterial/fungal infections in critically ill patients: A prospective observational study |
| title_fullStr | Biomarkers for differentiation of coronavirus disease 2019 or extracorporeal membrane oxygenation related inflammation and bacterial/fungal infections in critically ill patients: A prospective observational study |
| title_full_unstemmed | Biomarkers for differentiation of coronavirus disease 2019 or extracorporeal membrane oxygenation related inflammation and bacterial/fungal infections in critically ill patients: A prospective observational study |
| title_short | Biomarkers for differentiation of coronavirus disease 2019 or extracorporeal membrane oxygenation related inflammation and bacterial/fungal infections in critically ill patients: A prospective observational study |
| title_sort | biomarkers for differentiation of coronavirus disease 2019 or extracorporeal membrane oxygenation related inflammation and bacterial fungal infections in critically ill patients a prospective observational study |
| topic | diagnosis differential specificity and sensitivity co-infection interleukin-10 intensive care unit extracorporeal membrane oxygenation (ECMO) |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2022.917606/full |
| work_keys_str_mv | AT matthiasweisstessbach biomarkersfordifferentiationofcoronavirusdisease2019orextracorporealmembraneoxygenationrelatedinflammationandbacterialfungalinfectionsincriticallyillpatientsaprospectiveobservationalstudy AT matthiasweisstessbach biomarkersfordifferentiationofcoronavirusdisease2019orextracorporealmembraneoxygenationrelatedinflammationandbacterialfungalinfectionsincriticallyillpatientsaprospectiveobservationalstudy AT franzratzinger biomarkersfordifferentiationofcoronavirusdisease2019orextracorporealmembraneoxygenationrelatedinflammationandbacterialfungalinfectionsincriticallyillpatientsaprospectiveobservationalstudy AT markusobermueller biomarkersfordifferentiationofcoronavirusdisease2019orextracorporealmembraneoxygenationrelatedinflammationandbacterialfungalinfectionsincriticallyillpatientsaprospectiveobservationalstudy AT heinzburgmann biomarkersfordifferentiationofcoronavirusdisease2019orextracorporealmembraneoxygenationrelatedinflammationandbacterialfungalinfectionsincriticallyillpatientsaprospectiveobservationalstudy AT thomasstaudinger biomarkersfordifferentiationofcoronavirusdisease2019orextracorporealmembraneoxygenationrelatedinflammationandbacterialfungalinfectionsincriticallyillpatientsaprospectiveobservationalstudy AT oliverrobak biomarkersfordifferentiationofcoronavirusdisease2019orextracorporealmembraneoxygenationrelatedinflammationandbacterialfungalinfectionsincriticallyillpatientsaprospectiveobservationalstudy AT monikaschmid biomarkersfordifferentiationofcoronavirusdisease2019orextracorporealmembraneoxygenationrelatedinflammationandbacterialfungalinfectionsincriticallyillpatientsaprospectiveobservationalstudy AT bernhardroessler biomarkersfordifferentiationofcoronavirusdisease2019orextracorporealmembraneoxygenationrelatedinflammationandbacterialfungalinfectionsincriticallyillpatientsaprospectiveobservationalstudy AT berndjilma biomarkersfordifferentiationofcoronavirusdisease2019orextracorporealmembraneoxygenationrelatedinflammationandbacterialfungalinfectionsincriticallyillpatientsaprospectiveobservationalstudy AT manuelkussmann biomarkersfordifferentiationofcoronavirusdisease2019orextracorporealmembraneoxygenationrelatedinflammationandbacterialfungalinfectionsincriticallyillpatientsaprospectiveobservationalstudy AT ludwigtraby biomarkersfordifferentiationofcoronavirusdisease2019orextracorporealmembraneoxygenationrelatedinflammationandbacterialfungalinfectionsincriticallyillpatientsaprospectiveobservationalstudy |