Новый полуколичественный экспресс-тест на прокальцитонин у госпитализированных пациентов с внебольничной пневмонией различной степени тяжести

Abstract

Background: severe community-acquired pneumonia (CAP) makes a significant contribution to the structure of population disability and mortality, therefore, its timely diagnosis and treatment are conductive to the prevention of complications and the preservation of working capacity. A potential biomarker for the early diagnosis of severe CAP is plasma procalcitonin (PCT). Aim: to evaluate the PCT level, determined by a new semi-quantitative rapid test (RT), as a biomarker associated with the CAP severity. Patients and Methods: the study included 123 patients hospitalized with a diagnosis of community-acquired pneumonia. In the first 24 hours of hospitalization, all patients underwent general clinical examination and chest X-ray examination. The level of PCT plasma was determined using a new semi-quantitative RT and quantitative test. According to the results of the examinations, the patients were divided into 2 groups: hospitalized in the specialized pulmonology department with moderate severity of pneumonia (n=117) and hospitalized in the intensive care unit (ICU) with severe disease severity (n=6); the mean age was 49.1±21.1 and 55.7±17.5 years, respectively (p=0.460). Results: for patients with CAP hospitalized in the specialized department, negative and borderline values of PCT RT prevailed: indicators <0.5 ng/mL were recorded in 70.1% of patients, levels ranged ≥0.5, but <2 ng/mL — in 21.4% (p=0.001). Positive values of PCT RT prevailed in patients with in the ICU: ≥2 ng/mL, but <10 ng/mL — in 16.7%, ≥10 ng/mL — in 66.7% (p=0.001). The indicators of quantitative PCT were significantly higher in patients with severe CAP — 10.80 [4.21; 61.63] ng/mL and 0.14 [0.09; 0.67] ng/mL (p=0.003). PCT RT ≥2 ng/mL with respect to severe CAP, the optimal sensitivity was 83.3%, specificity — 91.5%, the area under the ROC curve — 0.87. The diagnostic significance was assessed as very good. Conclusion: the new plasma PCT RT can be used at the first stages of the diagnosis of severe CAP in inpatients, which will optimize intra- hospital routing of patients in medical and preventive treatment facility and, respectively, determine the treatment tactics. KEYWORDS: semi-quantitative plasma procalcitonin rapid test, community-acquired pneumonia, condition severity. FOR CITATION: Bayramova S.S., Tsygankova O.V., Nikolaev K.Yu. New semi-quantitative rapid test for procalcitonin in hospitalized patients with community-acquired pneumonia of varying severity. Russian Medical Inquiry. 2022;6(7):344–351 (in Russ.). DOI: 10.32364/2587- 6821-2022-6-7-344-351.