Procalcitonin In Patients Research Articles

D-Dimer and procalcitonin in patients with recurrent pericarditis: a prospective study.

Recurrent pericarditis, an inflammatory syndrome with a pathogenesis not fully elucidated, often presents diagnostic challenges. This study aims to assess the correlation of D-Dimer (D-D) and procalcitonin (PCT) levels with clinical, laboratory and imaging features in recurrent idiopathic pericarditis. We analyzed 412 patients with idiopathic recurrent pericarditis from 2019 to 2023 in our referral center. D-D and PCT values were obtained from emergency room in other Italian facilities. Among the cohort, PCT levels were assessed in 50 of 412 patients (12.1%), with only 4 showing marginal elevation. D-D levels were measured in 48 of 412 patients (11.6%), with 33 of them exhibiting elevated values. None of these patients had venous thromboembolism, and elevated D-D levels were significantly associated with pleural effusion, fever, higher CRP, increased white blood cell counts, higher neutrophil counts, reduced relative lymphocyte counts. Multivariate analysis revealed fever as the sole correlate of elevated D-D. PCT elevation was infrequent and unrelated to any variables. In idiopathic recurrent pericarditis unrelated to specific conditions, we observed a close association between elevated D-D levels and non-specific inflammation markers, including fever, increased CRP, and neutrophil leukocytosis. PCT levels were typically normal or mildly elevated.

Effect of Renin-Angiotensin-Aldosterone System Blockers on Adverse Outcomes in COVID-19 Patients.

Angiotensin-converting enzyme 2 (ACE2) of the renin-angiotensin-aldosterone system (RAAS) serves as a functional receptor to gain entry into the cells for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19). The interaction between SARS-CoV-2 and ACE2 is a potential virulent factor in infectivity. Our study aimed to ascertain the association of RAAS inhibitors with adverse cardiovascular and other outcomes in hospitalized COVID-19 patients. This is a retrospective study of medical records of ≥18-year-old patients hospitalized for COVID-19 from March 2020 to October 2020. Primary outcomes were acute cardiovascular events (ST-elevation myocardial infarction, non-ST-elevation myocardial infarction type 1, acute congestive heart failure, acute stroke) and mortality. Secondary outcomes were respiratory failure, need for and duration of mechanical ventilation, acute deep vein thrombosis or pulmonary embolism (DVT/PE), and readmission rate. Among 376 hospitalized COVID-19 patients, 149 were on RAAS inhibitors. No statistically significant differences were found between RAAS inhibitor and non-RAAS inhibitor groups with respect to acute cardiovascular events (6% vs. 6.2%, p = 0.94), acute DVT/PE (4.7% vs. 4.8%, p = 0.97), hypoxia (62.4% vs. 58.6%, p = 0.46), need for mechanical ventilation (18.1% vs. 16.7%, p = 0.72), mortality (19.5% vs. 22%, p = 0.56), and readmission rate (11.4% vs. 14.1%, p = 0.45). Some nuances discovered were a higher rate of hospitalizations among Native Americans receiving RAAS inhibitors (30.2% vs. 19.8%) and significantly lower levels of procalcitonin in patients on RAAS inhibitors. Among hospitalized patients with COVID-19, those on RAAS inhibitors showed no significant differences in acute cardiovascular events, acute DVT/PE, hypoxia, need for mechanical ventilation, readmission, or mortality rate compared to those not on them. However, further large-scale studies are needed to validate these findings.

The Role of Vitamin D-Binding Protein, and Procalcitonin in Patients with Arthritis on Vitamin D

The Role of Vitamin D-Binding Protein, and Procalcitonin in Patients with Arthritis on Vitamin D

Diagnostic value of procalcitonin in patients with periprosthetic joint infection: a diagnostic meta-analysis.

The success rate of periprosthetic joint infection (PJI) treatment is still low. Early diagnosis is the key to successful treatment. Therefore, it is necessary to find a biomarker with high sensitivity and specificity. The diagnostic value of serum procalcitonin (PCT) for PJI was systematically evaluated to provide the theoretical basis for clinical diagnosis and treatment in this study. We searched the Web of Science, Embase, Cochrane Library, and PubMed for studies that evaluated the diagnostic value of serum PCT for PJI (from the inception of each database until September 2020). Two authors independently screened the literature according to the inclusion and exclusion criteria. The quality of each selected literature was evaluated by using the Quality Assessment of Diagnostic Accuracy Studies tool (QUADAS-2) tool. RevMan 5.3 software was used for the quality evaluation. The sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were merged by using Meta-DiSc 1.4 software. The area under the curve (AUC) and Q index were calculated after the summary receiver operating characteristic (SROC) was generated. We also performed subgroup analysis. A total of 621 patients were enrolled in the nine studies. The pooled sensitivity of serum PCT for PJI diagnosis was 0.441 [95% confidence interval (CI), 0.384-0.500], the pooled specificity was 0.852 (95% CI, 0.811-0.888), the pooled PLR was 2.271 (95% CI, 1.808-2.853), the pooled NLR was 0.713 (95% CI, 0.646-0.786), and the pooled DOR was 5.756 (95% CI, 3.673-9.026). The area under SROC (the pooled AUC) was 0.76 (0.72-0.79). Q index was 0.6948. This study showed that PCT detection of PJI had poor diagnostic accuracy. Hence, the serum PCT is not suitable as a serum marker for PJI diagnosis.

The Role of Interleukin-6 and Procalcitonin in Kidney Patients have Bacterial and Viral Infection

Background: IL-6 is one of the most studied cytokines in kidney disease. It is making inflammation worse by activating B cells that affect the production of hepatic acute phase proteins. It is also involved in metabolic, regenerative, and neurological processes Procalcitonin (PCT) is a typical biomarker for bacterial infections. since it increases in response to bacterial infections but not to other inflammatory reactions such as viral infections. Aim: study the role of IL-6 and PCT on renal failure that is affected by bacterial and viral infection. Methods: Between January and April 2023, 120 patients were confirmed to have chronic renal failure with or without diabetes mellitus who were affected or not via bacterial or viral infections based on previous medical reports and were divided into six groups; each of them included 20 patients. IL-6 and PCT levels were assayed and compared among groups. Different groups had very significantly different levels of IL-6 (90.40±25.77 for patients in G1, 42.33±17.32 for patients in G2, 84.95±19.80 for patients in G3, and 36.68±15.10 for patients in G4). The levels were 2.44±0.79 for patients in G5 and 2.26±0.59 for the control group, respectively (p<0.0001). The levels of PCT were also significantly different between groups (4.77±1.86 for patients in G1; 0.31±0.09 for patients in G2; 4.41±1.43 for patients in G3; 0.28±0.09 for patients in G4). The levels were 0.04±0.01 for patients in G5 and 0.03±0.01 for the control group, respectively (p<0.0001). Results: The findings demonstrated significant in levels of interleukin-6, urea, and creatinine in all patients except diabetic patients and significant increase in the level of procalcitonin in patients who have a bacterial infection, not a viral infection. Conclusion: The level of IL-6 increases in renal failure in both bacterial and viral infection states, but the Procalcitonin level increases in bacterial infection only.

ECMO in Myocardial Infarction-Associated Cardiogenic Shock: Blood Biomarkers as Predictors of Mortality.

Veno-arterial extracorporeal membrane oxygenation (va-ECMO) can provide circulatory and respiratory support in patients with cardiogenic shock. The main aim of this work was to investigate the association of blood biomarkers with mortality in patients with myocardial infarction needing va-ECMO support. We retrospectively analyzed electronic medical charts from patients receiving va-ECMO support in the period from 2008 to 2021 at the Medical University Innsbruck, Department of Anesthesiology and Intensive Care Medicine. Of 188 patients, 57% (108/188) survived to discharge, with hemorrhage (46%) and thrombosis (27%) as the most frequent adverse events. Procalcitonin levels were markedly higher in non-survivors compared with survivors during the observation period. The multivariable model identified higher blood levels of procalcitonin (HR 1.01, p = 0.002) as a laboratory parameter associated with a higher risk of mortality. In our study population of patients with myocardial infarction-associated cardiogenic shock, deceased patients had increased levels of inflammatory blood biomarkers throughout the whole study period. Increased procalcitonin levels have been associated with a higher risk of mortality. Future studies are needed to show the role of procalcitonin in patients receiving ECMO support.

Utility of a Novel Clinical Scoring System and its Association with Procalcitonin in Patients of Acute Heart Failure with Respiratory Infections: A Limited Resource Perspective

Abstract Background: Heart failure (HF) is a global health burden that is usually simple to diagnose, but concomitant respiratory infections are difficult to distinguish clinically. Inflammatory markers can be used to differentiate between the two conditions, especially procalcitonin (PCT), one of the most specific markers for bacterial infections. PCT-guided antibiotic treatment has shown good results and could help in decreasing the indiscriminate prescription of antibiotics in HF patients. Methodology: A prospective observational study was carried out in a tertiary care hospital in Western India. Three hundred HF patients were separated into either high- or low-PCT level groups. A novel clinical score for clinically suspecting superimposed respiratory infection in acute HF patients was devised and its association with PCT level was measured. Results: 62.87 years was the average age of the study population with a male preponderance. While breathlessness was the presenting complaint in all 300 patients, the presence of fever and edema was significantly associated with raised PCT. A higher total leukocyte count and neutrophil count were seen in patients with high PCT. A higher incidence of consolidation, pulmonary edema, and pulmonary hypertension was noted in those with high PCT. A significant association was found between the clinical scoring system and the PCT level. Conclusion: The novel clinical scoring system has a satisfactory sensitivity, specificity, positive predictive value, and negative predictive value in diagnosing superimposed respiratory infections in acute HF patients. It can aid in the judicious use of the PCT test in resource-limited settings.

229. Predictive markers for bacteremia in patients receiving extracorporeal membrane oxygenation (ECMO) support

Abstract Background Patients receiving extracorporeal membrane oxygenation (ECMO) support are critically ill, which can confound the usual metrics clinician use to diagnose bacteremia. The best methods to detect bacteremia in patients receiving ECMO support are unknown, and we sought to evaluate the accuracy of various metrics used in determining bacteremia. Methods A retrospective review of patients receiving ECMO support at Yale New Haven Hospital from April 2020 to September 2021 who had blood cultures obtained for any reason was performed. Reasons for blood culture and metrics associated with bacteremia, including white blood cell count (WBC), maximum daily temperature, and procalcitonin, were evaluated for each blood culture event. If patients became bacteremic, only the first positive blood cultures were included in the analysis. Receiver operator curves for each metric were performed to generate areas under the curve (AUC) for assessing diagnostic accuracy. Results 60 patients who required ECMO support had 132 blood cultures performed, 22 (16.7%) with bacteremia and 110 (83.3%) without. In blood cultures with bacteremia compared to those without, there was no difference in WBC count (17.4 vs 17.9, p = 0.825), maximum daily temperature (37.1 vs 36.9 C, p = 0.572), or procalcitonin (2.0 vs 2.2, p = 0.776) on the day of culture. The most predictive reason for obtaining blood cultures with confirmed bacteremia was hemodynamic instability (AUC 0.668), followed by temperature dysregulation (AUC 0.623). Reasons for obtaining blood cultures minimally associated with bacteremia included adding ice to the ECMO circuit (AUC 0.527), leukocytosis (AUC 0.523), respiratory decompensation (AUC 0.500), surveillance culturing (AUC 0.432), and other reasons not specified but per clinician discretion (AUC 0.386). Conclusion Hemodynamic instability as the reason for obtaining blood cultures was the most predictive of bacteremia in patients on ECMO support, while leukocytosis, temperature change, and surveillance cultures were less well associated. There was no difference in WBC counts, maximum daily temperature, and procalcitonin in patients with bacteremia versus those without. Optimizing clinical criteria to determine bacteremia in patients on ECMO remains challenging and warrants further study. Disclosures All Authors: No reported disclosures

Prognostic value of procalcitonin in patients with cirrhosis hospitalized for acute infection

Background: In patients with cirrhosis, infections significantly increase the risk of short and long-term mortality. During infection, the levels of procalcitonin increase, but it has not yet been clarified its prognostic value in subjects with cirrhosis. Therefore, the aim of this study was to evaluate the prognostic role of procalcitonin in patients with liver cirrhosis hospitalized for acute infection, and to compare it with other markers of infection. Patients: We included 279 patients hospitalized because of infection, 133 with liver cirrhosis. At admission the levels of the main biochemical parameters of infection, i.e. leukocytes, procalcitonin, C reactive protein and lactate, were considered. Results: The duration of hospitalization and antibiotic therapy were longer in patients with cirrhosis, while no difference was observed for mortality. In both groups, a correlation with the duration of hospitalization and antibiotic therapy was observed for high levels of procalcitonin. In the cirrhotic population, in particular, higher procalcitonin values were associated with an increase in the length of hospitalization and antibiotic therapy, suggesting an even greater predictive value for those patients. High levels of leucocytes and lactate were positively associated with the duration of hospitalization, but not with the duration of antibiotic therapy. For mortality, the strongest correlation was found for high serum lactate levels, regardless of the presence of cirrhosis. Conclusion: In patients with cirrhosis and acute infection, the value of procalcitonin at admission is a good prognostic indicator for the course of hospitalization, and could be useful for guiding the management and treatment of hospitalized patients.

Diagnostic usefulness of serum procalcitonin in patients with bacterial sepsis.

The Sequential Organ Failure Assessment (SOFA) score is used for the diagnosis of sepsis and involves clinical and laboratory parameters that may not be readily and/or timely available in most resource-poor settings. Procalcitonin (PCT) has its level changed in response to bacterial sepsis and its measurement costs only a fraction of the total cost of investigations required to calculate SOFA score. This study aims to determine the diagnostic usefulness of PCT in bacterial sepsis. Ninety-nine participants were studied, divided into three groups: apparently healthy volunteers, those with bacterial infection without sepsis (SOFA score <2), and patients with bacterial sepsis (positive culture and SOFA ≥2). PCT level of each participant was measured and median group levels compared. Pearson's correlation was used to determine the correlation between serum PCT levels and SOFA scores in the sepsis group using a significance level of 5 percent (P < 0.05). Diagnostic usefulness of PCT was assessed using receiver operating characteristic (ROC). Positive correlation was found between serum PCT levels and SOFA scores among patients with sepsis r = 0.42, P = 0.016. At a concentration of ≥4.25 ng/ml, serum PCT as a surrogate for SOFA score had a sensitivity and specificity of 57.60% and 84.80%, respectively, for indicating sepsis. The area under the ROC curve (AUC) was 0.74 (95% CI {0.62 to 0.86}, P = 0.001). Serum PCT concentration was significantly higher in bacterial sepsis compared to bacterial infection without sepsis and healthy state. PCT concentration demonstrated positive correlation with SOFA score in bacterial sepsis and can be used as surrogate for sepsis screening/monitoring in resource-poor settings.

Diagnostic Performance Evaluation of Cerebrospinal Fluid Procalcitonin in Patients with Bacterial Meningitis from Sourô Sanou University Hospital, Burkina Faso

Diagnostic Performance Evaluation of Cerebrospinal Fluid Procalcitonin in Patients with Bacterial Meningitis from Sourô Sanou University Hospital, Burkina Faso

Impact of the COVID-19 Pandemic on the Epidemiology of Bloodstream Infections in Hospitalized Patients-Experience from a 4th Military Clinical Hospital in Poland.

Retrospective and prospective data were collected from blood cultures obtained from 4289 patients hospitalized between June 2018 and July 2022. Two groups of patients were distinguished: those with BSIs admitted during the pre-COVID-19 period and those admitted during the COVID-19 surge. Demographic and clinical data, blood cytology, and biochemistry results were analyzed, and the usefulness of PCT was assessed in patients with COVID-19. The study showed a significant increase in the incidence of BSIs during the pandemic compared to the pre-COVID-19 period. Positive blood cultures were obtained in 20% of patients hospitalized during the pandemic (vs. 16% in the pre-COVID-19 period). The incidence of BSIs increased from 1.13 to 2.05 cases per 1000 patient days during COVID-19, and blood culture contamination was more frequently observed. The mortality rate was higher for patients hospitalized during the COVID-19 pandemic. An increased frequency of MDRO isolation was observed in the COVID-19 period. The incidence of BSIs increased and the mortality rate was higher in the COVID-19 period compared to the pre-COVID-19 period. The study showed limited usefulness of procalcitonin in patients with COVID-19, likely due to the administered immunosuppressive therapy.

Prognostic value of platelet combined with serum procalcitonin in patients with sepsis.

Sepsis, a common and life-threatening condition in critically ill patients, is a leading cause of death in intensive care units. Over the past few decades, there has been significant improvement in the understanding and management of sepsis. However, the mortality rate remains unacceptably high, posing a prominent challenge in modern medicine and a significant global disease burden. A total of 295 patients with sepsis admitted to the hospital from January 2021 to December 2022 were collected and divided into survival group and death group according to their 28-day survival status. The differences in general clinical data and laboratory indicators between the 2 groups were compared. Receiver operating characteristic curve analysis was used to evaluate the predictive value of platelet (PLT) and procalcitonin (PCT) for the prognosis of sepsis patients within 28 days. A total of 295 patients were diagnosed with sepsis, and 79 died, with a mortality rate of 26.78%. The PLT level in the death group was lower than that in the survival group; the PCT level in the death group was higher than that in the survival group. The receiver operating characteristic curve showed that the area under the curve of PCT and PLT for evaluating the prognosis of sepsis patients were 0.808 and 0.804, respectively. Kaplan-Meier survival analysis showed that the 28-day survival rate of the low PLT level group was 19.0% and that of the high PLT level group was 93.1% at the node of 214.97 × 109/L, and the difference between the 2 groups was statistically significant (χ2 = 216.538, P < .001). The 28-day survival rate of the low PCT level group was 93.4% and that of the high PCT level group was 51.7% at the node of 2.85 ng/mL, and the difference between the 2 groups was statistically significant (χ2 = 63.437, P < .001). There was a negative correlation between PCT level and PLT level (r = -0.412, P < .001). Platelet combined with serum procalcitonin detection has high predictive value for judging the 28-day prognosis of sepsis, and it can be used as an index for evaluating the patient's condition and prognosis, and is worthy of clinical promotion and application.

Study of Procalcitonin Level in Obese Prevalent Hemodialysis Patients and Its Relation to Hemodialysis Adequacy

Abstract Introduction In hemodialysis (HD) patients procalcitonin considered as an early predictor of acute infection. It represents a new and potential marker of inflammation and may correlate with dialysis adequacy. This makes procalcitonin a potential biomarker for obesity-related low-grade inflammation. Objective To assess procalcitonin level in obese prevalent hemodialysis patients and its relation to hemodialysis adequacy Methods A cross sectional study was conducted on 90 patients divided into 3 groups, 40 obese (BMI ≥ 30 Kg/m2) ESRD patients on regular hemodialysis at dialysis unit of El-Sahel Teaching Hospital (group A), 40 non obese (BMI &amp;lt; 25 Kg/m2) ESRD patients on regular hemodialysis (group B) and 10 healthy individuals with BMI &amp;lt; 25 Kg/m2 as a control group (group C).All patients were subjected to detailed history taking and general examination. All patients were laboratory investigated for CBC, serum urea, creatinine, CRP, Urea reduction ratio (URR), equilibrated Kt/v. All controls were subjected to written informed consent, full history and examination and CRP level. Procalcitonin level was done by ELISA technique for all patients and control. Results In our study, we found that there was a higher level of procalcitonin (PCT) in obese hemodialysis patient than non-obese. We also found that there was no correlation between PCT and hemodialysis adequacy in our study population. Conclusion Our study showed that procalcitonin is a potential biomarker for obesity-related low-grade inflammation. But not related to hemodialysis adequacy.

An Observational Study on Levels of Serum Fibrin Degradation Product (FDP), D-Dimer and Procalcitonin in Burn Sepsis

Background: Despite improvements in burn management, infection is still the biggest challenge in major burn cases globally. Burn causes extensive tissue destruction, immune dysfunction, increases the risk of infection and septicemia with high morbidity and mortality. The aim of this study was to observe the levels of serum fibrin degradation product (FDP), D-dimer and procalcitonin in patients with burn sepsis treated in intensive care unit (ICU). Materials &amp; Methods: This observational study was carried out in Department of Burn and Plastic Surgery, Dhaka Medical College Hospital, Dhaka from February 2018 to January 2019. Forty (40) patients with major burns, from (15% to 50% total body surface area burn) with burn sepsis, were recruited for the study. In all cases, plasma level of fibrin degradation product (FDP), D-dimer and procalcitonin were measured and recorded. Result: Male predominance (57.5%) was observed in our study. Eighty five percent (85%) patients had total body surface area burn (TBSA) 20% to 50%. Sixteen patients (40%) suffered from flame burn, 13 (32.5%) patients from scalds and 11 (27.5%) patients had high voltage electric burn. The value of FDP was raised in 62.5% patients, D- dimer in 67.5% patients. Serum procalcitonin level was high (&gt; 2ng/ml), indicating burn sepsis in 47.5% cases but it was not significant (2 sample t – test reveals no significant relationship between rise of serum level of procalcitonin and presence of burn sepsis) Conclusion: Fibrin degradation product (FDP) and D- dimer were raised in two-thirds of burn cases while procalcitonin in two-fifths cases. Measurement of serum level of FDP, Ddimer and procalcitonin may give an idea regarding early onset of bacterial infection and burn sepsis and can serve as an indicator for burn sepsis. J Bangladesh Coll Phys Surg 2023; 41: 193-197

The levels of cartonectin and procalcitonin in patients with chronic periodontitis and hypertension

Abstract Objectives This study aimed to examine the effects of chronic periodontitis and essential hypertension on serum and salivary cartonectin (CTRP3) and procalcitonin (ProCT) levels. Methods Sixty non-smokers were seperated into four groups as; 15 people with essential hypertension (EH) and chronic periodontitis (CP) (HT+ CP+), 15 with EH (HT+ CP−), 15 with CP (HT− CP+), 15 control (HT− CP−). PPD, CAL, PI and GI were measured. All groups had their serum and saliva samples collected. Serum and saliva procalcitonin (ProCT) were measured using an electroluminescence method, and cartonectin (CTRP3) levels were determined by enzyme-linked immunosorbent assay. Results When compared to the control group, serum and saliva cartonectin (CTRP3) levels were considerably lower in all groups (respectively p&lt;0.0001, p&lt;0.0001). The serum cartonectin (CTRP3) levels were substantially higher in the HT− CP+ group than in the HT+ CP− group (p=0.002). Serum procalcitonin (ProCT) concentrations were found to be lowest in the HT− CP− group and highest in the HT+ CP+ group. Serum ProCT concentrations did not vary significantly across groups (p=0.110). Salivary procalcitonin (ProCT) levels were below the detection limit in all groups. Conclusions When periodontitis coexist with hypertension in individuals, they may have adversely affect each other due to the same sathways in the pathogenesis of these two disorders. So we can suggest that, serum and saliva cartonectin (CTRP3) may play a role during hypertension and periodontal inflammation and represent a novel future therapeutic target.

Correlation between Leukocyte Count and Lymphatic Neutrophil Ratio to Procalcitonin in Covid-19 Confirmed Patients at Gresik Regional General Hospital

Covid-19 is a new type of virus that attacks the respiratory system and can infect humans, which can cause respiratory illness and death from acute pneumonia. Hematology and procalcitonin are laboratory investigations that are often used. This study aims to determine the relationship between the results of the examination of the leukocyte count and the ratio of neutrophil lymphocytes to procalcitonin in patients with confirmed Covid-19. This type of research uses a cross sectional design using a purposive random sampling technique that uses secondary data. Research data collection was carried out in June 2022 at the Ibnu Sina Gresik Hospital Laboratory. Statistical test using Spearman correlation test. Based on the results of the study, it was found p = 0.481, indicating that the results were not statistically significant with the correlation coefficient (r) showing a negative value of 0.134, so it can be concluded that there is a very weak relationship between the number of leukocytes and procalcitonin in patients with confirmed Covid-19. A decrease in the number of leukocytes by 1 cell/µl can increase procalcitonin levels by 0.134 ng/ml and based on the results p = 0.491 indicating that the results are not statistically significant with a correlation coefficient value (r) of 0.131 so that it shows a very weak correlation between the ratio relationship neutrophil lymphocytes to procalcitonin in patients with confirmed Covid-19.

Prognostic Value of Serum Procalcitonin in Patients with Sepsis in a Tertiary Level Hospital

Background: Sepsis is a complex, life-threatening, heterogeneous infectious disease associated with increased rates of morbidity and mortality. Early assessment of the prognosis of sepsis is key to achieving a favorable outcome for the disease. This study aimed to identify the prognostic value of PCT for sepsis patients. Materials and Methods: We conducted a prospective analytical study involving 100 adult patients with sepsis who were admitted to the Medicine dept and intensive care unit from 2019 to 2020. At least one blood test for PCT level was performed for all patients within the first 24 hours of suspecting an infection. Results: Our study found that a maximum number of patients (43.0%) were between 51-60 years age group, mean age of the patient was 49.35 ± 11.7 years. Out of 100 cases, 65% were male and 35% were female. The male and female ratio was 1.85:1. In this study serum, procalcitonin levels 0.5-2.0 ng/were detected in 15.0% of patients with mean±SD 1.3±0.8. Serum procalcitonin levels 2.1-10.0 ng/mL were detected in 29.0% of patients with mean±SD 5.9±2.5 and &gt;10.0 ng/mL was detected in 56 patients. Based on the receiver-operator characteristic (ROC) curves, procalcitonin had the area under curve 0.923, with 89.4% sensitivity and 87.5% specificity. In our study, procalcitonin showed the best predictive value for the short-term outcome of sepsis with a cut-off value of 14.8 ng/mL (AUC 0.923). Study shows that 76.0% of the patients recovered completely, but 24.0% of patients expired during the hospital stay. Conclusion: There was a statistically significant correlation in serum procalcitonin with the outcome of sepsis (p &lt; 0.001). So the effectiveness of serum procalcitonin has proven significant in the prediction of mortality in sepsis patients. J MEDICINE 2023; 24: 18-22

CORRELATION BETWEEN HEPCIDIN AND PROCALCITONIN AND THEIR DIAGNOSTIC ROLE IN PATIENTS WITH COVID-19.

The aim: The purpose of this study is to find out the association between procalcitonin and hepcidin in patients with COVID-19, in addition to their role as diagnostic markers. Materials and methods: A total of 75 patients infected with coronavirus were included in the current study, their age is ranging between 20 to 78 years. Those patients was hospitalized in Al-Sadr Teaching Hospital in Najaf, in Iraq. This study also included 50 healthy subjects which are volunteers and considered as a (control group). Biomarker (procalcitonin and hepcidin) measurements were achieved by electrochemiluminescent immunoassay (ECLIA) in the Elecsys immunoassay system. Results: The present study showed a significant increase the serum cencentration of hepcidin and procalcitonin in patients with COVID-19 as compared tohealthy subjects. There was a highly significant increasing(p < 0.01) in hepcidin and PCT level in patients with severe infection comparing to other catgaries.The current study also revealed that the sensitivity values of the markers were: 0.88%, 0.85 for procalcitonin and hepcidin respectively, which indicate high diagnostic power. Conclusions: Serum levels of hepcidin and procalcitonin are increased as inflammatory markers in COVID-19 patients with relatively high sensitivity. It seems that these imflammatory markers obviously elevate in the severe cases COVID-19dusease.

274. Epidemiology and Antimicrobial Treatment Impact of Procalcitonin in Patients with COVID-19

Abstract Background Procalcitonin (PCT) is often measured in patients with signs of bacterial infection. PCT is often elevated in bacterial pneumonia and septic shock and usually low in viral infections. Recent studies have found a correlation between PCT and disease severity in COVID-19, and most patients receive antibiotics despite bacterial co-infection being rare. We sought to characterize PCT trends in COVID-19, assess its relation to bacterial pneumonia, and assess its relation to clinical decision making around antimicrobial use. Methods We included patients ≥18 hospitalized at Michigan Medicine (3/1/20–10/31/21), positive for COVID-19, with ≥ 1 PCT measurement. Structured query was used to retrospectively extract data. Patients started on an antibiotic underwent retrospective chart review by 2 reviewers for presence of bacterial pneumonia (bPNA), and were classified as having proven, probable, possible, or no bPNA (Figure 1). Multivariable models controlling for time from start of the pandemic, demographics, and comorbidities were used to determine associations of PCT and bPNA with antimicrobial use. Figure 1:Flow diagram of patients included in analyses Results 793 patients met inclusion criteria, with 224 (28.2%) initiated on antibiotics. Of these 224, 33 (14.7%) had proven/probable bPNA, 125 (55.8%) had possible bPNA, and 66 (29.5%) had no bPNA. On average, patients had 2.6 ±3.7 (mean ±SD) PCT measurements, with 4.1 ±5.2 if on antibiotics vs. 2.0 ±2.6 if not. Initial PCT was higher in those on antibiotics and highest in those with proven/probable bPNA (Table 1). After adjustment for confounders, initial PCT was associated with antibiotic initiation (OR 1.68, 95% CI 1.47-1.91, p &amp;lt; 0.0001) (Table 2). Initial PCT (RR 1.11, 95% CI 1.03-1.20, p=0.008), change in PCT over time (RR 1.03, 95% CI 1.01-1.05, p=0.007), and bPNA category (RR 1.51, 95% CI 1.23-1.84, p &amp;lt; 0.0001) were associated with antibiotic duration (Table 3). Table 1:Number of PCT measures by antibiotic and bPNA statusTable 2:Multivariable logistic regression model results for covariate associations with antibiotic initiation (n=793)Table 3:Multivariable negative binomial model results for covariate associations with antibiotic duration (n=224) Conclusion PCT was elevated in patients with COVID-19, but more pronounced with bPNA. Antibiotics were started in &amp;gt; 25% of patients, regardless of bPNA. PCT trends associate with the decision to initiate antibiotics and treatment duration, independent of bPNA and comorbidities. Future prospective studies should determine if PCT can be used to safely make decisions around antibiotic treatment for bacterial infection during COVID-19. Disclosures Krishna Rao, MD, MS, Merck &amp; Co., Inc.: Grant/Research Support|Seres Therapeutics: Advisor/Consultant|Summit Therapeutics: Advisor/Consultant.