Abstract
PurposeCoronavirus disease-2019 (COVID-19) is associated with a wide spectrum of clinical symptoms including acute respiratory failure. Biomarkers that can predict outcomes in patients with COVID-19 can assist with patient management. The aim of this study is to evaluate whether procalcitonin (PCT) can predict clinical outcome and bacterial superinfection in patients infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2).MethodsAdult patients diagnosed with SARS-CoV-2 by nasopharyngeal PCR who were admitted to a tertiary care center in Boston, MA with SARS-CoV-2 infection between March 17 and April 30, 2020 with a baseline PCT value were studied. Patients who were presumed positive for SARS-CoV-2, who lacked PCT levels, or who had a positive urinalysis with negative cultures were excluded. Demographics, clinical and laboratory data were extracted from the electronic medical records.Results324 patient charts were reviewed and grouped by clinical and microbiologic outcomes by day 28. Baseline PCT levels were significantly higher for patients who were treated for true bacteremia (p = 0.0005) and bacterial pneumonia (p = 0.00077) compared with the non-bacterial infection group. Baseline PCT positively correlated with the NIAID ordinal scale and survival over time. When compared to other inflammatory biomarkers, PCT showed superiority in predicting bacteremia.ConclusionsBaseline PCT levels are associated with outcome and bacterial superinfection in patients hospitalized with SARS-CoV-2.
Highlights
Coronavirus disease-2019 (COVID-19) was declared a global pandemic by the World Health Organization (WHO) in 2020
The aim of this study is to evaluate whether procalcitonin (PCT) can predict clinical outcome and bacterial superinfection in patients infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)
Baseline PCT levels were significantly higher for patients who were treated for true bacteremia (p = 0.0005) and bacterial pneumonia (p = 0.00077) compared with the non
Summary
Coronavirus disease-2019 (COVID-19) was declared a global pandemic by the World Health Organization (WHO) in 2020. It was first reported in Wuhan, China, and SARS-CoV-2, a single stranded RNA virus, was identified as the causative pathogen [1,2,3,4]. Mild symptoms of COVID-19 infection are characterized by fever, dry cough, fatigue, and myalgia, and for some, bacterial superinfection may develop. It remains difficult to predict which patients will develop bacterial superinfection and who will have poor outcomes. Due to the severity of COVID-19, a lack of initial treatment options and concerns for untreated concurrent bacterial infection, there has been widespread use of antimicrobials in the management of COVID-19 patients [7,8,9,10,11], potentially driving antimicrobial resistance, higher rates of Clostridioides difficile colitis and medication side-effects
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