Elucidating the role of procalcitonin as a biomarker in hospitalized COVID-19 patients

Kelsie Cowman; James Rossi; Inessa Gendlina; Yi Guo; Sichen Liu; Wendy Szymczak; Stefanie K. Forest; Lucia Wolgast; Erika Orner; Hongkai Bao; Miguel E. Cervera-Hernandez; Ashley G. Ceniceros; Raja Thota; Liise anne Pirofski; Priya Nori

doi:10.1016/j.diagmicrobio.2022.115721

Elucidating the role of procalcitonin as a biomarker in hospitalized COVID-19 patients

Kelsie Cowman, James Rossi, Inessa Gendlina, Yi Guo, Sichen Liu, Wendy Szymczak, Stefanie K. Forest, Lucia Wolgast, Erika Orner, Hongkai Bao, Miguel E. Cervera-Hernandez, Ashley G. Ceniceros, Raja Thota, Liise anne Pirofski, Priya Nori

Research output: Contribution to journal › Article › peer-review

9 Scopus citations

Abstract

Our objectives were to evaluate the role of procalcitonin in identifying bacterial co-infections in hospitalized COVID-19 patients and quantify antibiotic prescribing during the 2020 pandemic surge. Hospitalized COVID-19 patients with both a procalcitonin test and blood or respiratory culture sent on admission were included in this retrospective study. Confirmed co-infection was determined by an infectious diseases specialist. In total, 819 patients were included; 335 (41%) had an elevated procalcitonin (>0.5 ng/mL) and of these, 42 (13%) had an initial bacterial co-infection. Positive predictive value of elevated procalcitonin for co-infection was 13% while the negative predictive value was 94%. Ninety-six percent of patients with an elevated procalcitonin received antibiotics (median 6 days of therapy), compared to 82% with low procalcitonin (median 4 days of therapy) (adjusted OR:3.3, P < 0.001). We observed elevated initial procalcitonin in many COVID patients without concurrent bacterial co-infections which potentially contributed to antibiotic over-prescribing.

Original language	English (US)
Article number	115721
Journal	Diagnostic Microbiology and Infectious Disease
Volume	103
Issue number	4
DOIs	https://doi.org/10.1016/j.diagmicrobio.2022.115721
State	Published - Aug 2022

Keywords

Antimicrobial stewardship
Bacterial co-infection
COVID-19
Procalcitonin

ASJC Scopus subject areas

Microbiology (medical)
Infectious Diseases

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.diagmicrobio.2022.115721

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Cowman, K., Rossi, J., Gendlina, I., Guo, Y., Liu, S., Szymczak, W., Forest, S. K., Wolgast, L., Orner, E., Bao, H., Cervera-Hernandez, M. E., Ceniceros, A. G., Thota, R., Pirofski, L. A., & Nori, P. (2022). Elucidating the role of procalcitonin as a biomarker in hospitalized COVID-19 patients. Diagnostic Microbiology and Infectious Disease, 103(4), Article 115721. https://doi.org/10.1016/j.diagmicrobio.2022.115721

Cowman, K, Rossi, J, Gendlina, I , Guo, Y, Liu, S, Szymczak, W , Forest, SK , Wolgast, L , Orner, E , Bao, H, Cervera-Hernandez, ME, Ceniceros, AG, Thota, R, Pirofski, LA & Nori, P 2022, 'Elucidating the role of procalcitonin as a biomarker in hospitalized COVID-19 patients', Diagnostic Microbiology and Infectious Disease, vol. 103, no. 4, 115721. https://doi.org/10.1016/j.diagmicrobio.2022.115721

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abstract = "Our objectives were to evaluate the role of procalcitonin in identifying bacterial co-infections in hospitalized COVID-19 patients and quantify antibiotic prescribing during the 2020 pandemic surge. Hospitalized COVID-19 patients with both a procalcitonin test and blood or respiratory culture sent on admission were included in this retrospective study. Confirmed co-infection was determined by an infectious diseases specialist. In total, 819 patients were included; 335 (41%) had an elevated procalcitonin (>0.5 ng/mL) and of these, 42 (13%) had an initial bacterial co-infection. Positive predictive value of elevated procalcitonin for co-infection was 13% while the negative predictive value was 94%. Ninety-six percent of patients with an elevated procalcitonin received antibiotics (median 6 days of therapy), compared to 82% with low procalcitonin (median 4 days of therapy) (adjusted OR:3.3, P < 0.001). We observed elevated initial procalcitonin in many COVID patients without concurrent bacterial co-infections which potentially contributed to antibiotic over-prescribing.",

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AU - Rossi, James

AU - Gendlina, Inessa

AU - Guo, Yi

AU - Liu, Sichen

AU - Szymczak, Wendy

AU - Forest, Stefanie K.

AU - Wolgast, Lucia

AU - Orner, Erika

AU - Bao, Hongkai

AU - Cervera-Hernandez, Miguel E.

AU - Ceniceros, Ashley G.

AU - Thota, Raja

AU - Pirofski, Liise anne

AU - Nori, Priya

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N2 - Our objectives were to evaluate the role of procalcitonin in identifying bacterial co-infections in hospitalized COVID-19 patients and quantify antibiotic prescribing during the 2020 pandemic surge. Hospitalized COVID-19 patients with both a procalcitonin test and blood or respiratory culture sent on admission were included in this retrospective study. Confirmed co-infection was determined by an infectious diseases specialist. In total, 819 patients were included; 335 (41%) had an elevated procalcitonin (>0.5 ng/mL) and of these, 42 (13%) had an initial bacterial co-infection. Positive predictive value of elevated procalcitonin for co-infection was 13% while the negative predictive value was 94%. Ninety-six percent of patients with an elevated procalcitonin received antibiotics (median 6 days of therapy), compared to 82% with low procalcitonin (median 4 days of therapy) (adjusted OR:3.3, P < 0.001). We observed elevated initial procalcitonin in many COVID patients without concurrent bacterial co-infections which potentially contributed to antibiotic over-prescribing.

AB - Our objectives were to evaluate the role of procalcitonin in identifying bacterial co-infections in hospitalized COVID-19 patients and quantify antibiotic prescribing during the 2020 pandemic surge. Hospitalized COVID-19 patients with both a procalcitonin test and blood or respiratory culture sent on admission were included in this retrospective study. Confirmed co-infection was determined by an infectious diseases specialist. In total, 819 patients were included; 335 (41%) had an elevated procalcitonin (>0.5 ng/mL) and of these, 42 (13%) had an initial bacterial co-infection. Positive predictive value of elevated procalcitonin for co-infection was 13% while the negative predictive value was 94%. Ninety-six percent of patients with an elevated procalcitonin received antibiotics (median 6 days of therapy), compared to 82% with low procalcitonin (median 4 days of therapy) (adjusted OR:3.3, P < 0.001). We observed elevated initial procalcitonin in many COVID patients without concurrent bacterial co-infections which potentially contributed to antibiotic over-prescribing.

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Elucidating the role of procalcitonin as a biomarker in hospitalized COVID-19 patients

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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