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Procalcitonin and secondary bacterial infections in COVID-19: association with disease severity and outcomes

Natale Vazzana1, Francesco Dipaola1, Silvia Ognibene1

  • 1Department of Internal Medicine, 'C. Magati' Hospital, AUSL Reggio Emilia, Scandiano, Italy.

Acta Clinica Belgica
|September 23, 2020
PubMed

Insights

Elevated procalcitonin (PCT) levels in COVID-19 patients indicate a higher risk of severe disease and adverse outcomes. However, PCT

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Biomarkers

Background:

  • Procalcitonin (PCT) is an emerging prognostic marker for coronavirus disease 2019 (COVID-19).
  • The utility of PCT in detecting secondary bacterial infections and reflecting target tissue injury in COVID-19 remains unclear.
  • This meta-analysis reviews the prognostic value of PCT for severe disease and adverse outcomes in COVID-19 patients.

Purpose of the Study:

  • To evaluate the prognostic value of procalcitonin (PCT) in predicting severe coronavirus disease 2019 (COVID-19).
  • To assess the association of PCT with adverse outcomes in COVID-19 patients.
  • To explore the role of PCT in identifying secondary bacterial infections and guiding antibiotic therapy.

Main Methods:

  • A meta-analysis was conducted on data from relevant publications.
  • Studies reporting categorical data on disease severity and/or outcomes were included.
  • Data were analyzed using fixed or random-effects meta-analysis models based on heterogeneity.

Main Results:

  • Data from 14 studies involving 3492 patients were analyzed.
  • Elevated PCT was associated with a significantly higher risk of severe disease (OR: 5.92) and adverse outcomes (OR: 13.1).
  • Secondary bacterial infections (4.7%-19.5%) were linked to an increased risk of severe or fatal outcomes (OR: 20.8).

Conclusions:

  • Elevated PCT levels can identify COVID-19 patients at increased risk for severe disease and adverse outcomes.
  • Limitations include low sensitivity and an undefined cost-utility ratio for PCT.
  • The role of PCT in detecting secondary bacterial infections and guiding antibiotic therapy in COVID-19 requires further investigation.
Abstract

Keywords:
COVID-19infectionsprocalcitoninsevere disease

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