Evaluation of procalcitonin elevation during ICU stay and its relationship with mortality in ICU patients for COVID-19 with respiratory involvement. A multicenter prospective cohort study
IntroductionA multicenter prospective cohort study studied patients admitted to the intensive care unit (ICU) by coronavirus-19 (COVID-19) with respiratory involvement. We observed the number of occasions in which the value of procalcitonin (PCT) was higher than 0.5 ng/ml.ObjectiveEvaluation of PCT...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-12-01
|
| Series: | Frontiers in Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2022.972659/full |
| _version_ | 1811296275484639232 |
|---|---|
| author | Ricardo Rivera-Fernandez Luis Yáguez-Mateos María Guerrero-Marin Rosa María Pérez-Manrique Rosa María Pérez-Manrique María Rojas-Amezcua Antonio Jesús Pontes-Moreno Juan José Ríos-Toro Rosa Vela-Colmenero María Isabel Ruiz-Garcia Crispín Colmenero-Aguilar Ana Castillo-Rivera María Dolores Pola-Gallego de Guzmán Eduardo Aguilar-Alonso |
| author_facet | Ricardo Rivera-Fernandez Luis Yáguez-Mateos María Guerrero-Marin Rosa María Pérez-Manrique Rosa María Pérez-Manrique María Rojas-Amezcua Antonio Jesús Pontes-Moreno Juan José Ríos-Toro Rosa Vela-Colmenero María Isabel Ruiz-Garcia Crispín Colmenero-Aguilar Ana Castillo-Rivera María Dolores Pola-Gallego de Guzmán Eduardo Aguilar-Alonso |
| author_sort | Ricardo Rivera-Fernandez |
| collection | DOAJ |
| description | IntroductionA multicenter prospective cohort study studied patients admitted to the intensive care unit (ICU) by coronavirus-19 (COVID-19) with respiratory involvement. We observed the number of occasions in which the value of procalcitonin (PCT) was higher than 0.5 ng/ml.ObjectiveEvaluation of PCT elevation and influence on mortality in patients admitted to the ICU for COVID-19 with respiratory involvement.Measurements and main resultsWe studied 201 patients. On the day of admission, acute physiology and chronic health evaluation (APACHE)-II was 13 (10–16) points. In-hospital mortality was 36.8%. During ICU stay, 104 patients presented 1 or more episodes of PCT elevation and 60 (57.7%) died and 97 patients did not present any episodes of PCT elevation and only 14 (14.4%) died (p < 0.001). Multivariable analysis showed that mortality was associated with APACHE-II: [odds ratio (OR): 1.13 (1.04–1.23)], acute kidney injury [OR: 2.21 (1.1–4.42)] and with the presentation of one or more episodes of escalating PCT: [OR: 5.07 (2.44–10.53)]. Of 71 patients who died, 59.2% had an elevated PCT value on the last day, and of the 124 patients who survived, only 3.2% had an elevated PCT value on the last day (p < 0.001). On the last day of the ICU stay, the sequential organ failure assessment (SOFA) score of those who died was 9 (6–11) and 1 (0–2) points in survivors (p < 0.001). Of the 42 patients who died and in whom PCT was elevated on the last day, 71.4% were considered to have a mainly non-respiratory cause of death.ConclusionIn patients admitted to the ICU by COVID-19 with respiratory involvement, numerous episodes of PCT elevation are observed, related to mortality. PCT was elevated on the last day in more than half of the patients who died. Serial assessment of procalcitonin in these patients is useful because it alerts to situations of high risk of death. This may be useful in the future to improve the treatment and prognosis of these patients. |
| first_indexed | 2024-04-13T05:46:50Z |
| format | Article |
| id | doaj.art-abe44fe01e9040b58775bf69a6914dcb |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-04-13T05:46:50Z |
| publishDate | 2022-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-abe44fe01e9040b58775bf69a6914dcb2022-12-22T02:59:56ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-12-01910.3389/fmed.2022.972659972659Evaluation of procalcitonin elevation during ICU stay and its relationship with mortality in ICU patients for COVID-19 with respiratory involvement. A multicenter prospective cohort studyRicardo Rivera-Fernandez0Luis Yáguez-Mateos1María Guerrero-Marin2Rosa María Pérez-Manrique3Rosa María Pérez-Manrique4María Rojas-Amezcua5Antonio Jesús Pontes-Moreno6Juan José Ríos-Toro7Rosa Vela-Colmenero8María Isabel Ruiz-Garcia9Crispín Colmenero-Aguilar10Ana Castillo-Rivera11María Dolores Pola-Gallego de Guzmán12Eduardo Aguilar-Alonso13Intensive Care Unit, University Hospital of Jaén, Jaén, SpainIntensive Care Unit, University Hospital of Jaén, Jaén, SpainIntensive Care Unit, University Hospital of Jaén, Jaén, SpainIntensive Care Unit, Hospital of Montilla, Córdoba, SpainProgram in Clinical Medicine and Public Health, University of Granada, Granada, SpainIntensive Care Unit, Infanta Margarita Hospital, Córdoba, SpainIntensive Care Unit, Hospital San Agustín, Jaén, SpainIntensive Care Unit, Hospital of Serrania of Ronda, Málaga, SpainIntensive Care Unit, University Hospital of Jaén, Jaén, SpainIntensive Care Unit, University Hospital of Jaén, Jaén, SpainIntensive Care Unit, University Hospital of Jaén, Jaén, SpainIntensive Care Unit, University Hospital of Jaén, Jaén, SpainIntensive Care Unit, University Hospital of Jaén, Jaén, SpainIntensive Care Unit, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Reina Sofía University Hospital, Córdoba, SpainIntroductionA multicenter prospective cohort study studied patients admitted to the intensive care unit (ICU) by coronavirus-19 (COVID-19) with respiratory involvement. We observed the number of occasions in which the value of procalcitonin (PCT) was higher than 0.5 ng/ml.ObjectiveEvaluation of PCT elevation and influence on mortality in patients admitted to the ICU for COVID-19 with respiratory involvement.Measurements and main resultsWe studied 201 patients. On the day of admission, acute physiology and chronic health evaluation (APACHE)-II was 13 (10–16) points. In-hospital mortality was 36.8%. During ICU stay, 104 patients presented 1 or more episodes of PCT elevation and 60 (57.7%) died and 97 patients did not present any episodes of PCT elevation and only 14 (14.4%) died (p < 0.001). Multivariable analysis showed that mortality was associated with APACHE-II: [odds ratio (OR): 1.13 (1.04–1.23)], acute kidney injury [OR: 2.21 (1.1–4.42)] and with the presentation of one or more episodes of escalating PCT: [OR: 5.07 (2.44–10.53)]. Of 71 patients who died, 59.2% had an elevated PCT value on the last day, and of the 124 patients who survived, only 3.2% had an elevated PCT value on the last day (p < 0.001). On the last day of the ICU stay, the sequential organ failure assessment (SOFA) score of those who died was 9 (6–11) and 1 (0–2) points in survivors (p < 0.001). Of the 42 patients who died and in whom PCT was elevated on the last day, 71.4% were considered to have a mainly non-respiratory cause of death.ConclusionIn patients admitted to the ICU by COVID-19 with respiratory involvement, numerous episodes of PCT elevation are observed, related to mortality. PCT was elevated on the last day in more than half of the patients who died. Serial assessment of procalcitonin in these patients is useful because it alerts to situations of high risk of death. This may be useful in the future to improve the treatment and prognosis of these patients.https://www.frontiersin.org/articles/10.3389/fmed.2022.972659/fullprocalcitoninCOVID-19respiratory involvementICUsepsis–diagnostics |
| spellingShingle | Ricardo Rivera-Fernandez Luis Yáguez-Mateos María Guerrero-Marin Rosa María Pérez-Manrique Rosa María Pérez-Manrique María Rojas-Amezcua Antonio Jesús Pontes-Moreno Juan José Ríos-Toro Rosa Vela-Colmenero María Isabel Ruiz-Garcia Crispín Colmenero-Aguilar Ana Castillo-Rivera María Dolores Pola-Gallego de Guzmán Eduardo Aguilar-Alonso Evaluation of procalcitonin elevation during ICU stay and its relationship with mortality in ICU patients for COVID-19 with respiratory involvement. A multicenter prospective cohort study Frontiers in Medicine procalcitonin COVID-19 respiratory involvement ICU sepsis–diagnostics |
| title | Evaluation of procalcitonin elevation during ICU stay and its relationship with mortality in ICU patients for COVID-19 with respiratory involvement. A multicenter prospective cohort study |
| title_full | Evaluation of procalcitonin elevation during ICU stay and its relationship with mortality in ICU patients for COVID-19 with respiratory involvement. A multicenter prospective cohort study |
| title_fullStr | Evaluation of procalcitonin elevation during ICU stay and its relationship with mortality in ICU patients for COVID-19 with respiratory involvement. A multicenter prospective cohort study |
| title_full_unstemmed | Evaluation of procalcitonin elevation during ICU stay and its relationship with mortality in ICU patients for COVID-19 with respiratory involvement. A multicenter prospective cohort study |
| title_short | Evaluation of procalcitonin elevation during ICU stay and its relationship with mortality in ICU patients for COVID-19 with respiratory involvement. A multicenter prospective cohort study |
| title_sort | evaluation of procalcitonin elevation during icu stay and its relationship with mortality in icu patients for covid 19 with respiratory involvement a multicenter prospective cohort study |
| topic | procalcitonin COVID-19 respiratory involvement ICU sepsis–diagnostics |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2022.972659/full |
| work_keys_str_mv | AT ricardoriverafernandez evaluationofprocalcitoninelevationduringicustayanditsrelationshipwithmortalityinicupatientsforcovid19withrespiratoryinvolvementamulticenterprospectivecohortstudy AT luisyaguezmateos evaluationofprocalcitoninelevationduringicustayanditsrelationshipwithmortalityinicupatientsforcovid19withrespiratoryinvolvementamulticenterprospectivecohortstudy AT mariaguerreromarin evaluationofprocalcitoninelevationduringicustayanditsrelationshipwithmortalityinicupatientsforcovid19withrespiratoryinvolvementamulticenterprospectivecohortstudy AT rosamariaperezmanrique evaluationofprocalcitoninelevationduringicustayanditsrelationshipwithmortalityinicupatientsforcovid19withrespiratoryinvolvementamulticenterprospectivecohortstudy AT rosamariaperezmanrique evaluationofprocalcitoninelevationduringicustayanditsrelationshipwithmortalityinicupatientsforcovid19withrespiratoryinvolvementamulticenterprospectivecohortstudy AT mariarojasamezcua evaluationofprocalcitoninelevationduringicustayanditsrelationshipwithmortalityinicupatientsforcovid19withrespiratoryinvolvementamulticenterprospectivecohortstudy AT antoniojesuspontesmoreno evaluationofprocalcitoninelevationduringicustayanditsrelationshipwithmortalityinicupatientsforcovid19withrespiratoryinvolvementamulticenterprospectivecohortstudy AT juanjoseriostoro evaluationofprocalcitoninelevationduringicustayanditsrelationshipwithmortalityinicupatientsforcovid19withrespiratoryinvolvementamulticenterprospectivecohortstudy AT rosavelacolmenero evaluationofprocalcitoninelevationduringicustayanditsrelationshipwithmortalityinicupatientsforcovid19withrespiratoryinvolvementamulticenterprospectivecohortstudy AT mariaisabelruizgarcia evaluationofprocalcitoninelevationduringicustayanditsrelationshipwithmortalityinicupatientsforcovid19withrespiratoryinvolvementamulticenterprospectivecohortstudy AT crispincolmeneroaguilar evaluationofprocalcitoninelevationduringicustayanditsrelationshipwithmortalityinicupatientsforcovid19withrespiratoryinvolvementamulticenterprospectivecohortstudy AT anacastillorivera evaluationofprocalcitoninelevationduringicustayanditsrelationshipwithmortalityinicupatientsforcovid19withrespiratoryinvolvementamulticenterprospectivecohortstudy AT mariadolorespolagallegodeguzman evaluationofprocalcitoninelevationduringicustayanditsrelationshipwithmortalityinicupatientsforcovid19withrespiratoryinvolvementamulticenterprospectivecohortstudy AT eduardoaguilaralonso evaluationofprocalcitoninelevationduringicustayanditsrelationshipwithmortalityinicupatientsforcovid19withrespiratoryinvolvementamulticenterprospectivecohortstudy |