Nonutility of procalcitonin for diagnosing bacterial pneumonia in patients with severe COVID-19
ABSTRACTBackground Patients hospitalized with COVID-19 are at significant risk for superimposed bacterial pneumonia. However, diagnosing superinfection is challenging due to its clinical resemblance to severe COVID-19. We therefore evaluated whether the immune biomarker, procalcitonin, could facilit...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2023-01-01
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| Series: | European Clinical Respiratory Journal |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/20018525.2023.2174640 |
| _version_ | 1797448941554368512 |
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| author | Avi J. Cohen Laura R. Glick Seohyuk Lee Yukiko Kunitomo Derek A. Tsang Sarah Pitafi Patricia Valda Toro Nicholas R. Ristic Ethan Zhang George B. Carey Rupak Datta Charles S. Dela Cruz Samir Gautam |
| author_facet | Avi J. Cohen Laura R. Glick Seohyuk Lee Yukiko Kunitomo Derek A. Tsang Sarah Pitafi Patricia Valda Toro Nicholas R. Ristic Ethan Zhang George B. Carey Rupak Datta Charles S. Dela Cruz Samir Gautam |
| author_sort | Avi J. Cohen |
| collection | DOAJ |
| description | ABSTRACTBackground Patients hospitalized with COVID-19 are at significant risk for superimposed bacterial pneumonia. However, diagnosing superinfection is challenging due to its clinical resemblance to severe COVID-19. We therefore evaluated whether the immune biomarker, procalcitonin, could facilitate the diagnosis of bacterial superinfection.Methods We retrospectively identified 185 patients hospitalized with severe COVID-19 who underwent lower respiratory culture; 85 had evidence of bacterial superinfection. Receiver operating characteristic curve and area under the curve (AUC) analyses were performed to assess the utility of procalcitonin for diagnosing superinfection.Results This approach demonstrated that procalcitonin measured at the time of culture was incapable of distinguishing patients with bacterial infection (AUC, 0.52). The AUC not affected by exposure to antibiotics, treatment with immunomodulatory agents, or timing of procalcitonin measurement.Conclusion Static measurement of procalcitonin does not aid in the diagnosis of superinfection in severe COVID-19. |
| first_indexed | 2024-03-09T14:17:45Z |
| format | Article |
| id | doaj.art-7af48bfb26164f3ca4980395de65ea5d |
| institution | Directory Open Access Journal |
| issn | 2001-8525 |
| language | English |
| last_indexed | 2024-03-09T14:17:45Z |
| publishDate | 2023-01-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | European Clinical Respiratory Journal |
| spelling | doaj.art-7af48bfb26164f3ca4980395de65ea5d2023-11-28T19:19:58ZengTaylor & Francis GroupEuropean Clinical Respiratory Journal2001-85252023-01-0110110.1080/20018525.2023.2174640Nonutility of procalcitonin for diagnosing bacterial pneumonia in patients with severe COVID-19Avi J. Cohen0Laura R. Glick1Seohyuk Lee2Yukiko Kunitomo3Derek A. Tsang4Sarah Pitafi5Patricia Valda Toro6Nicholas R. Ristic7Ethan Zhang8George B. Carey9Rupak Datta10Charles S. Dela Cruz11Samir Gautam12Department of Internal Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, Yale University School of Medicine, New Haven, CT, USADepartment of Internal Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, Yale University School of Medicine, New Haven, CT, USADepartment of Internal Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, Yale University School of Medicine, New Haven, CT, USAJohns Hopkins Hospital, Department of Internal Medicine, Section of Pulmonary and Critical Care Medicine, Baltimore, MD, USADepartment of Internal Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, Yale University School of Medicine, New Haven, CT, USADepartment of Internal Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, Yale University School of Medicine, New Haven, CT, USADepartment of Internal Medicine, University of California San Francisco, San Francisco, CA, USADepartment of Internal Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, Yale University School of Medicine, New Haven, CT, USADepartment of Internal Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, Yale University School of Medicine, New Haven, CT, USADepartment of Internal Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, Yale University School of Medicine, New Haven, CT, USAVeterans Affairs Connecticut Healthcare System, Hospital Epidemiology and Infection Prevention Program, West Haven, CT, USADepartment of Internal Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, Yale University School of Medicine, New Haven, CT, USADepartment of Internal Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, Yale University School of Medicine, New Haven, CT, USAABSTRACTBackground Patients hospitalized with COVID-19 are at significant risk for superimposed bacterial pneumonia. However, diagnosing superinfection is challenging due to its clinical resemblance to severe COVID-19. We therefore evaluated whether the immune biomarker, procalcitonin, could facilitate the diagnosis of bacterial superinfection.Methods We retrospectively identified 185 patients hospitalized with severe COVID-19 who underwent lower respiratory culture; 85 had evidence of bacterial superinfection. Receiver operating characteristic curve and area under the curve (AUC) analyses were performed to assess the utility of procalcitonin for diagnosing superinfection.Results This approach demonstrated that procalcitonin measured at the time of culture was incapable of distinguishing patients with bacterial infection (AUC, 0.52). The AUC not affected by exposure to antibiotics, treatment with immunomodulatory agents, or timing of procalcitonin measurement.Conclusion Static measurement of procalcitonin does not aid in the diagnosis of superinfection in severe COVID-19.https://www.tandfonline.com/doi/10.1080/20018525.2023.2174640COVID-19procalcitonincritical carebacterial superinfectionpneumoniabiomarker |
| spellingShingle | Avi J. Cohen Laura R. Glick Seohyuk Lee Yukiko Kunitomo Derek A. Tsang Sarah Pitafi Patricia Valda Toro Nicholas R. Ristic Ethan Zhang George B. Carey Rupak Datta Charles S. Dela Cruz Samir Gautam Nonutility of procalcitonin for diagnosing bacterial pneumonia in patients with severe COVID-19 European Clinical Respiratory Journal COVID-19 procalcitonin critical care bacterial superinfection pneumonia biomarker |
| title | Nonutility of procalcitonin for diagnosing bacterial pneumonia in patients with severe COVID-19 |
| title_full | Nonutility of procalcitonin for diagnosing bacterial pneumonia in patients with severe COVID-19 |
| title_fullStr | Nonutility of procalcitonin for diagnosing bacterial pneumonia in patients with severe COVID-19 |
| title_full_unstemmed | Nonutility of procalcitonin for diagnosing bacterial pneumonia in patients with severe COVID-19 |
| title_short | Nonutility of procalcitonin for diagnosing bacterial pneumonia in patients with severe COVID-19 |
| title_sort | nonutility of procalcitonin for diagnosing bacterial pneumonia in patients with severe covid 19 |
| topic | COVID-19 procalcitonin critical care bacterial superinfection pneumonia biomarker |
| url | https://www.tandfonline.com/doi/10.1080/20018525.2023.2174640 |
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