Serum Procalcitonin Levels Research Articles

Determination of serum procalcitonin and total antioxidant capacity in patients of sepsis before and after treatment, in a tertiary care hospital

Introduction: Sepsis is a medical emergency, occurring due to the body's systemic immunological response to an infection. It is among the most common reasons for intensive care unit admissions worldwide and is one of the top 10 leading causes of death worldwide. Procalcitonin (PCT) is the marker of sepsis, and total antioxidant capacity (TAC) is a marker of oxidative stress and gives a mirror image about patient's antioxidant status. The purpose of the study was to estimate serum PCT and TAC levels in sepsis patients, before and after treatment, and to find the correlation between them. Materials and Methods: In this observational follow-up study, 60 sepsis patients were recruited using purposive sampling method, and samples were taken before and after treatment. Separated serum was used to measure PCT and TAC. PCT was measured by a rapid quantitative test using a sandwich immunodetection method based on fluorescence immunoassay technology, on a Finecare FIA system. Values over 0.5 ng/ml were considered significant. TAC was measured using the ferric-reducing antioxidant power method based on reduction of a colorless Fe3+-TPTZ on interaction with a potential antioxidant, into an intense blue Fe2+-TPTZ complex. Results: The mean PCT in subjects before treatment was as high as 40.62 ± 12.02 ng/ml, and the difference between before and after treatment values was highly significant (P = 0.000). For TAC also, before treatment value was higher (485.64 ± 106.53 μm/l) than the after treatment (277.79 ± 74.17 μm/l) value with a significantly high difference (P = 0.000). Furthermore, a strong positive correlation between PCT and TAC (r = 0.754, P = 0.000) was observed. Conclusion: It was concluded that in sepsis, there is a concomitant existence of inflammation and oxidative stress. Since TAC values correlate with values of PCT, TAC could be a reliable prognostic marker and may be helpful in evaluating interventions on follow-up of patients.

Emphysematous liver abscess with Edwardsiella tarda infection.

This report presents the case of a 51-year-old woman on an immunosuppressant drug and steroids, who presented with general fatigue and was admitted to the intensive care unit. Her serum procalcitonin, lactate, aspartate aminotransferase, and alanine aminotransferase levels and white blood cell counts were elevated. Computed tomography revealed gas formation in her liver, and her culture results revealed Edwardsiella tarda and Escherichia coli infections. She underwent percutaneous transhepatic abscess drainage in addition to antimicrobial administration. She was discharged after 40 days. Cases of emphysematous liver abscess with Edwardsiella tarda infections are rarely reported in the literature and may present in patients with poorly controlled type 2 diabetes. The fatality rate associated with the condition is markedly high.

A study on biomarkers of sepsis and potential role of procalcitonin and ferritin marker in diagnosis, prognosis and treatment.

ABSTRACTObjectives:To evaluate the potential value of serum procalcitonin and serum ferritin levels in patients with clinically suspected and proven sepsis and their comparison with established inflammatory markers like C-reactive protein (CRP) and total leukocyte count.Materials and Methods:A total of 60 clinically suspected cases of sepsis were included in this study and each patient was investigated for serum S. ferritin, procalcitonin, and CRP and blood cultures using the BacT/Alert system.Results:Serum procalcitonin at a cut-off value of >2 ng/ml is a valuable biomarker for early diagnosis in sepsis patients due to bacterial infection and has a greater predictive value than serum ferritin, CRP, or any other biomarkers.

Interest of Procalcitonin Measurement in Children with Cerebral Malaria in Southern Benin

Introduction: Cerebral malaria is a major complication of the Plasmodium falciparum infection with a high case fatality rate. The objective of this study was to determine the relationship between cerebral malaria and high serum procalcitonin (PCT) level in children. Method: This was a prospective descriptive and analytical cohort study conducted over 12 months, on a series of PCT blood tests in children aged 6 months to 15 years old hospitalized for cerebral malaria in the pediatric wards of four hospitals in southern Benin. The cerebral malaria diagnosis was done based on WHO criteria. Blood samples for PCT measurement were collected on admission, 24 hours and 48 hours after the malaria therapy initiation. Student’s test, Pearson’s chi2 test, Fisher’s test and Kruskal-Wallis test were used where appropriate. For all comparisons the difference was significant when p was less than 5%. Results: Sixty-five children were included in the study with a sex ratio of 1.41. The age group of children under 5 years was the most represented, at 57%. PCT levels were high in 92.3% of children at admission, 90.8% at 24 hours and 84.6% at 48 hours. Forty-nine children had a positive clinical outcome while 16 died (24.6%). PCT levels were generally high over the three days of hospitalization, but higher at admission in case of death (p = 0.000). The association between PCT level and parasitemia at admission was significant (p = 0.04). Conclusion: In the view of the results, blood PCT level measured at admission could be predictive of the disease outcome in children with cerebral malaria.

Utility of biomarkers in predicting complications and in-hospital mortality in patients with COVID-19

Objectives:To determine the association between the laboratory biomarkers (C-reactive protein (CRP), Ferritin, lactate dehydrogenase (LDH), Procalcitonin, and D-dimer) with complications and in-hospital mortality in COVID-19 patients.Methods:This single-center, cross-sectional study was conducted at the Department of Emergency Medicine of Aga Khan University Hospital from April 01, 2020, to July 31, 2020. Descriptive statistics were presented as Mean±SD and Median along with Range. The frequencies and percentages were calculated for all categorical variables. Univariate and multivariate analysis was carried out to evaluate the significant association between the laboratory biomarkers and in-hospital mortality.Results:A total of 310 adult COVID positive patients were included. The most common complication was acute respiratory distress syndrome (ARDS) (37.1%), followed by myocardial injury (MI) (10.7%), deep vein thrombosis (DVT) (0.6%), and pulmonary embolism (PE) (0.3%). In-hospital mortality was 15.2%. In univariate analysis, it was observed that increased values of all biomarkers were significantly associated with the prediction of in-hospital mortality using binary logistic regression analysis (OR > 1.0, P <0.05). In multivariate analysis, increased levels of LDH and D-dimer at admission were significantly associated with increased odds of mortality (P <0.05).Conclusion:Serum CRP, ferritin, Procalcitonin, LDH, and D-dimer levels at the time of admission can predict complications like ARDS and MI and also predict mortality in COVID-19 infection. Serum LDH and D-dimer are the best amongst them for predicting mortality.

Association of inflammatory and coagulation biomarkers with mortality in patients aged 60 years or older and hospitalized with COVID-19

Objectives: To analyze the association of inflammatory and coagulation biomarkers with mortality in geriatric patients with COVID-19. Methods: This is a retrospective cohort study of 206 patients aged 60 years or older who were hospitalized with COVID-19 at an intensive care unit. The analyzed variables were age, sex, length of hospital stay, and inflammatory biomarkers (C-reactive protein, neutrophil-to-lymphocyte ratio, procalcitonin, fibrinogen, ferritin, and d-dimer). We constructed a receiver operating characteristic curve and analyzed the area under the curve to evaluate the accuracy of biomarkers associated with mortality in patients with COVID-19. Results: Mean age was 72 (± 8) years. There were 101 deaths (49% of the total sample), which were significantly more frequent (p = 0.006) in the older age groups and were distributed as follows: 37.50% (60 – 69 years old); 50% (70 – 79 years old); 67.50% (80 – 89 years old); and 75% (over 90 years old). Mortality was associated with increased serum levels of procalcitonin, neutrophil-to-lymphocyte ratio, C-reactive protein, and d-dimer, and decreased fibrinogen levels. Neutrophil-to-lymphocyte ratio occupied the largest area under the receiver operating characteristic curve (area under the curve 0.859) in this group. Conclusions: In this study, inflammatory biomarkers neutrophil-to-lymphocyte ratio, procalcitonin, C-reactive protein, and d-dimer were associated with mortality in older patients with COVID-19 hospitalized at an intensive care unit, and neutrophil-to-lymphocyte ratio presented the best accuracy.

Procalcitonin levels in COVID-19 patients in a tertiary care center

BACKGROUND: Procalcitonin (PCT) is a glycoprotein calcitonin prohormone released by the thyroid parafollicular cells. In case of a microbial infection, PCT synthesis can be stimulated by the elevation of proinflammatory cytokines, including interleukin-6, interleukin-1b, and tumor necrosis factor-α. These mediators are massively involved in the so-called cytokine storm, typical of the progression from the viremic to the hyperinflammatory stage of COVID-19 and characterized by the onset of respiratory symptoms and interstitial pulmonary infiltrates. Thus, PCT elevation may represent a direct consequence of the COVID-19 cytokine storm and could also be interpreted as a “viral sepsis” syndrome.AIM: (1) To estimate serum PCT levels in patients with COVID-19 infection. (2) To access PCT level as a predictor of mortality.MATERIALS AND METHODS: A cross-sectional study was conducted on a total of 200 patients in Bengaluru during the study period from March 2021 to July 2021. A case record form with follow-up chart was used to record the duration of disease, history of treatment, and complications. Patients underwent biochemical investigations and PCT level.RESULTS: The study includes 200 patients; the majority were above 50 years of age group. Out of 200 patients, 170 were discharged and 30 died. The mean PCT level was 4.44 ± 45.34 ng/ml. PCT in those who are discharged was 1.25 ± 8.81 ng/ml and compared to those who died was 28.06 ± 128.4 ng/ml. This difference was statistically significant (P = 0.00).CONCLUSION: PCT can be used as a prognostic biomarker in COVID-19 patients; initially elevated levels may be used as a prognostic indicator of severity, deteriorating clinical picture, and even mortality.

Diagnostic role of procalcitonin serum level in hepatitis C virus-infected patients with spontaneous bacterial peritonitis

ObjectiveWe aimed at the evaluation of the role of quantification of serum procalcitonin (PCT) in the detection of spontaneous bacterial peritonitis (SBP) in hepatitis C-related cirrhosis before and after initiation of antibiotic therapy.BackgroundSBP is a lethal consequence of advanced cirrhosis. The outcome is heavily affected by early detection and treatment. PCT has been evaluated during acute bacterial infections and sepsis.Patients and methodsWe included 60 patients with ascites due to hepatitis C-related cirrhosis, who were divided in two groups: group 1 included 40 naïve patients with SBP, and group 2 included 20 patients with sterile ascites as a control. After history taking and clinical examination, full blood count, liver test profile, and renal functions were done. Moreover, C-reactive protein and erythrocyte sedimentation rate levels were measured. Serum PCT was measured by immunoassay. Diagnostic ascitic sample analysis was done for the polymorphonuclear leukocyte (PMNL) count, albumin levels, and ascetic fluid culture.ResultsSerum PCT was significantly elevated in group 1 before treatment than after treatment, as well as when compared with group 2. There was no statistically significant correlation between the change in the C-reactive protein level and that of the serum PCT before and after treatment in group 1. There is no significant correlation between increases in the serum PCT and the results of bacterial growth of ascetic fluid culture group before and after treatment.ConclusionPCT levels in the serum appear to provide a good diagnostic certainty in the diagnosis of SBP in cirrhotic patients at a cutoff value of 0.17 ng/ml for patients with either culture-positive or negative SBP.

The Relation of Standard Analgesia and Sedation Protocol in Intensive Care with Serum Procalcitonin Level

Giriş ve Amaç: Bu çalışmada, yoğun bakım hastalarının tedavi sürecinde ağrı düzeylerinin kontrolünde uygulanan standart sedo-analjezinin, bir enflamasyon belirteci olan serum prokalsitonini ile ilişkisinin saptanması amaçlanmıştır.&#x0D; Gereç ve Yöntemler: Araştırma, retrospektif olarak yoğun bakım kayıtlarından toplanan bilginin analizi ile gerçekleştirildi. Sedo-analjezi protokolü uygulanmadan önce hastaların ağrı tedavileri, hekim ve hemşirelerin düzensiz aralıklarla hastaları sübjektif değerlendirmeleri sonucuna göre, gereği halinde yapılmakta idi (1. Grup). Protokol ile güvenilir ölçeklerle, düzenli aralıklarla değerlendirilen ağrı ve sedasyon gereksinimleri, önceden kararlaştırılan ilaçlar ve dozlarla tedavi edilmeye başlandı (2. Grup). Hastaların prokalsitonin düzeyleri 5 gün süreyle sabah 1 kez ölçüldü. &#x0D; Bulgular: Parasetamol 2. grupta daha fazla kullanılmakla birlikte her iki grup arasında anlamlı fark saptanmadı. Tramadol 2. grupta istatistiksel olarak anlamlı oranda fazla kullanıldı. Fentanil dozu iki grup arasında anlamlı farklılık göstermedi. Sedasyon amaçlı kullanılan midazolam ise 2. grupta istatistiksel olarak anlamlı oranda daha az kullanıldı. Her iki grupta da prokalsitonin değerlerinin giderek azalma gösterme eğiliminde olduğu saptandı. 1. gün ile 5. gün arasındaki fark karşılaştırıldığında iki grup arasında istatistiksel olarak anlamlı farklılık saptanmadı (p= 0,56). Beş gün boyunca izlenen serum prokalsitonin median değerlerinin her iki grupta da benzer olduğu bulundu.&#x0D; Sonuç: Protokolize sedo-analjezi uygulaması yaptığımız olgularda prokalsitonin düzeylerinde bir farklılık saptamadık. Prokalsitoninin enfeksiyonda olduğu gibi ağrı takibinde de uygun bir belirteç olup olamayacağını anlamak için daha iyi standardize edilmiş hasta gruplarında ve daha geniş olgu serilerinde yeni araştırmalara gereksinim olduğu görüşündeyiz.

ROLE OF INTERLEUKIN-6 AND PROCALCITONIN AS INFLAMMATORY BIOMARKERS IN EVALUATING COVID-19 DISEASE SEVERITY ON HRCT CHESTAN EXPERIENCE AT CMH QUETTA

Objective: To explore the relation of Interleukin-6 and Procalcitonin with COVID-19 severity on high resolution computerized tomogram (HRCT) chest.&#x0D; Study Design: Randomized Control Trial (NCT04945811).&#x0D; Place and Duration of study: Pathology Department, Combined Military Hospital Quetta, from April 2020 to May 2021.&#x0D; Methodology: Serum Interleukin-6 and Procalcitonin of 100 consenting COVID-19 positive patients from April 2020 to May 2021 were assessed at Pathology department Combined Military Hospital Quetta and their levels were correlated with severity of lung involvement on HRCT Chest&#x0D; Results: Serum Interlukin-6 levels were significantly raised in 97 patients with mean levels of 20.43 ± 19.66 (pg/ml). Serum procalcitonin levels were also significantly raised in 95 patients with mean levels of 0.43 ± 0.24 (ng/ml).&#x0D; Conclusion: Interlukin-6 and procalcitonin are important biomarkers for diagnosis and predicting severity of COVID-19 pneumonia.

Assessment of C-reactive protein, procalcitonin and interlukin-6 as diagnostic aid for neonatal infections at a tertiary care center

Introduction and Aim: Neonatal infections are the leading cause of mortality among neonates after prematurity. The importance determining biological markers to be used as a diagnostic test to detect neonatal infections the in early stage of the disease is a challenge. The purpose of this study was to evaluate the usefulness &amp; sensitivity of various serological markers such as serum Procalcitonin, C-reactive protein and chemokine IL-6 for diagnosis of neonatal infections leading to sepsis in new born infants. Materials and Methods: This cross-sectional study was carried out among newborns admitted in neonatal intensive care unit (NICU) and meeting the selection criteria. Samples were collected for blood culture and ELISA was performed for detection of CRP, PCT &amp; IL-6. Results: A total of 300 newborns were included in this study from NICU of which 132 (44%) neonates was found to be blood culture positive. The most frequently isolated organisms were Klebsiella pneumoniae (26.5%), followed by Candida albicans (18.1%). In case of confirmed neonatal sepsis, significant higher levels of CRP, PCT and IL-6 were detected than in cases of probable sepsis. Serum procalcitonin levels exhibit highest sensitivity and specificity as 65.91% and 91.67% respectively. Conclusion: Serum procalcitonin has better diagnostic utility in terms of biological marker for the diagnosis of neonatal infections than C- reactive protein and Interleukin-6.

Kırım-Kongo Kanamalı Ateşi Hastalarında Prokalsitonin ve Laktat Düzeyinin Klinik Seyirle İlişkisi

Aim: Crimean-Congo hemorrhagic fever (CCHF) is a zoonotic infection characterized by fever and hemorrhage that is endemic to northeastern Turkey. This study aimed to examine the association between procalcitonin and venous blood gas parameters and clinical course and prognosis in patients with CCHF. Material and Methods: A total of 96 CCHF patients who were followed up in the infectious diseases department between March 2020 and September 2020 were included in the study. The patients’ routine laboratory tests, serum procalcitonin, and results of venous blood gas analysis were analyzed retrospectively. Results: There were statistically significant differences in serum platelet, aspartate transaminase, alanine transaminase, creatinine kinase, lactate dehydrogenase, potassium, C-reactive protein, sedimentation, D-dimer, activated partial thromboplastin time, ferritin, procalcitonin and lactate levels, and platelet/lymphocyte ratio among the patients with mild, moderate and severe disease (p=0.017 for potassium, p=0.004 for D-dimer, and p&amp;lt;0.001 for rest of others). In receiver operating characteristic curve analysis of serum lactate for the differentiation of patients with severe disease and those with mild/moderate disease, the area under curve was 0.802 and a cut-off value of 1.9 mmol/L had 77.8% sensitivity and 76.9% specificity. For serum procalcitonin, the area under curve was 0.892 and a cut-off value of 0.61 ng/mL had 83.3% sensitivity and 89.7% specificity. Conclusion: Serum procalcitonin and lactate level may be useful and easily obtained parameters to guide the evaluation of clinical severity and follow-up in patients with CCHF.

Teicoplanin combined with conventional vancomycin therapy for the treatment of pulmonary methicillin-resistant Staphylococcus aureus and Staphylococcus epidermidis infections.

BACKGROUNDVancomycin and teicoplanin are both antibiotics that have significant antimicrobial effects on Gram-positive cocci.AIMTo explore the value of teicoplanin combined with conventional (vancomycin only) anti-infective therapy for the treatment of methicillin-resistant Staphylococcus aureus and Staphylococcus epidermidis pulmonary infections.METHODSA total of 86 patients with methicillin-resistant Staphylococcus aureus or methicillin-resistant Staphylococcus epidermidis pulmonary infections, treated in our hospital between January 2018 and February 2020, were assigned to the study and control groups using a random number table method, with 43 patients in each group. The control group received conventional treatment (vancomycin), and the study group received both teicoplanin and conventional treatment. The following indicators were assessed in both groups: the time required for symptom relief, treatment effectiveness, serum levels of inflammatory factors (procalcitonin, interleukin-1β, tumor necrosis factor-α, C-reactive protein), clinical pulmonary infection scores before and after treatment, and the incidence of adverse reactions.RESULTSPatients in the study group were observed to have faster cough and expectoration resolution, white blood cell count normalization, body temperature normalization, and rales disappearance than patients in the control group (all P < 0.05); the total rate of effectiveness was 93.02% in the study group, higher than the 76.74% in the control group (P < 0.05). The pre-treatment serum levels of procalcitonin, interleukin-1β, tumor necrosis factor-α, and C-reactive protein as well as the clinical pulmonary infection scores were similar among the patients in both groups. However, the post-treatment serum levels of procalcitonin, interleukin-1β, tumor necrosis factor-α, and C-reactive protein as well as the clinical pulmonary infection scores were significantly lower in the study group than in the control group (P < 0.05). There was no significant difference in the incidence of adverse reactions between the groups.CONCLUSIONCompared with conventional (vancomycin only) therapy, teicoplanin and vancomycin combination therapy for patients with pulmonary methicillin-resistant Staphylococcus aureus and methicillin-resistant Staphylococcus epidermidis infections can improve patient clinical symptoms, modulate serum inflammatory factor levels, and improve treatment efficacy, without increasing the risk of adverse reactions.

Study of Monocyte Subsets and Their Surface Expression of CD86 and Serum IL-17 Compared to Serum Procalcitonin as Markers of Early Neonatal Sepsis.

IntroductionNeonatal sepsis can quickly progress to multi-organ failure with high morbidity and mortality, making early diagnosis mandatory. Although being the gold standard, the long duration of blood culture may lead to hazardous neonatal complications. Sepsis activates monocytes and changes their subset distribution with the resultant activation of lymphocytes and adaptive immune cells changing the plasma cytokines levels.Subjects and MethodPercentages of monocytes subsets, pattern of monocytes surface CD86 expression and serum IL-17 compared to serum procalcitonin were measured in 30 neonates with early sepsis and compared with age and sex matched 30 apparently health neonates as a control group.ResultsGestational age, neonatal weight and hemoglobin concentration were significantly low in septic neonates vs the control group. Percentages of intermediate, nonclassical and CD86 positive monocytes, the mean fluorescence intensity of CD16 on CD16 positive monocytes, and serum levels of CRP, IL-17 and procalcitonin were significantly increased in septic neonates compared with the control group.ConclusionEarly neonatal sepsis was associated with increasing the percentage of CD86 positive monocytes. Serum IL-17 levels were positively correlated with increased serum procalcitonin.

Asessment of Serum Procalcitonin Level in Patients with Chronic Obstructive Pulmonary Disease

Asessment of Serum Procalcitonin Level in Patients with Chronic Obstructive Pulmonary Disease

Predictors of 1‑year mortality in ambulatory patients with advanced heart failure awaiting heart transplant.

Heart failure (HF) is a complex syndrome involving diverse pathways and pathological processes that can manifest themselves in circulation as abnormal levels of various biomarkers. The aim of the study was to assess the factors associated with a worse prognosis in patients with advanced HF awaiting heart transplant during a 1‑year follow‑up. We prospectively assessed the data of 203 adult patients with advanced HF, who were hospitalized at our institution between 2016 and 2018. The study end point was all‑cause death during a 1‑year follow‑up. The median age of patients was 57 years (range, 52-60); 87.7% of patients were male. During follow‑up, 62 patients (30.5%) died. Serum levels of procalcitonin (hazard ratio [HR], 1.027; 95% CI, 1.020-1.034; P <0.001; per 10‑unit increase), high‑sensitivity C‑reactive protein (hs‑CRP; HR, 1.099; 95% CI, 1.016-1.883; P = 0.02; per 1‑unit increase), sodium (HR, 1.171; 95% CI, 1.076-1.272; P <0.001; per 1 ‑unit increase), and N ‑terminal pro-B ‑type natriuretic peptide (NT ‑proBNP; HR, 1.068; 95% CI, 1.033-1.105; P <0.001; per 1000‑unit increase) were independent risk factors for mortality. Procalcitonin generated the largest area under the curve (0.780; 95% CI, 0.712-0.848). Our study showed that higher serum hs ‑CRP, NT‑proBNP, and procalcitonin levels and lower serum sodium levels were independent risk factors for death during a 1‑year follow‑up in patients with advanced HF. Procalcitonin showed the strongest predictive power, sensitivity, and specificity, allowing for an effective identification of 1‑year survivors and nonsurvivors awaiting heart transplant.

Association Between Procalcitonin and Post-hepatectomy Liver Failure in Hepatocellular Carcinoma Patients.

Objectives: Procalcitonin (PCT) has long been proved as an early diagnostic signal for postoperative outcomes. The purpose of this study is to explore the value of serum procalcitonin levels in predicting post-hepatectomy liver failure (PHLF), and further to declarethe relationship between postoperative PCT and short-term prognosis in patients after hepatectomy. Methods: Clinical data of patients with hepatocellular carcinoma (HCC) who underwent hepatectomy from June 1st, 2019 to September 31st, 2020 at Shanghai Eastern Hepatobiliary Surgery Hospital had been retrospectively analyzed. Logistic regression analysis was used to evaluate the risk factors related to PHLF. The Kaplan-Meier method was used to calculate the PHLF rate and 30-day survival after surgery. Results: A total of 885 patients with complete data were finally included in analysis, 311 of them with elevated serum PCT (≥1 ng/ml). Results of the logistic regression analysis suggested a significant association between PCT and PHLF [HR, 95%CI; 3.801 (1.825, 7.917), p < 0.001]. Other significant risk factors for PHLF included portal hypertension, portal blocking time (>30 min) and blood transfusion (>200 ml). Kaplan-Meier analysis also suggested a higher PHLF rate in elevated PCT patients [9.0% (95% CI, 7.3 to 12.8 VS. 1.9% (95% CI, 1.1–4.3)); p < 0.001]. For secondary outcomes, elevated PCT was also highly associated with postoperative sepsis, ICU admission, 30-day mortality and 3-month mortality. Conclusion: Elevated procalcitonin level in patients after hepatectomy is related to higher PHLF rate, with lower 30-day survival and poor short-term postoperative outcomes.

Acute kidney injury in moderate and severe COVID-19 patients: Report of two university hospitals.

Acute kidney injury (AKI) is one of the most severe complications of SARS-CoV-2 infection. In a retrospective study, we aimed to describe the influence of COVID-19-related factors on the severity, outcome and timing of AKI in 268 patients admitted in two large COVID-19-designated university hospitals over a period of 6 months. In the univariate analysis, there was a significant relationship between KDIGO stage and the extension of COVID-19 pneumonia on computed tomography (CT), need for oxygen supplementation, serum levels of ferritin, interleukin-6, and procalcitonin, but none of these variables had a value for predicting KDIGO stage in multinomial regression. The odds of recovery of renal function were significantly diminished by d-dimer values. Lack of immunomodulatory treatment was found to be correlated with increased need for renal replacement therapy (RRT). Compared with AKI at admission, hospital-acquired AKI was predicted by the severity of lung damage on CT, evolved more frequently with incomplete recovery of renal function, and was significantly associated with antiviral therapy.

Biomarkers of inflammation and cytokine storm: a relationship with the production levels of virus-specific IgG isotype antibodies to SARS-CoV-2 N-protein in COVID-19 present and vaccinated persons

COVID-19 has become a planetary emergency which is seriously threatening human health. Comparative studies can shed light on the molecular mechanisms of the formation of humoral antiviral immunity in persons who have undergone the disease and have been vaccinated against the SARS-CoV-2 virus. Serum levels of biomarkers of inflammation and cytokine storm (procalcitonin, sCD14, sLBP, sTREM1, IL-6, IL-8, IL-10, sWnt5a, TNFα and TNFβ) were determined by enzyme immunoassay. We studied the relationship between the content of biomarkers in blood serum with low and high concentrations of antiviral antibodies, indirect indicators of which are the values of the positivity coefficient (CP). A significant increase in the serum levels of sTREM1, IL-6, and procalcitonin was found in persons with a high CP level after infection. A significant increase in IL-6 and PCT was revealed in persons vaccinated with the Sputnik V vaccine, both with a low level of CP and with a high one. In vaccinated individuals with a low CP level, a significant increase in the sTREM1 content was also observed. It has been shown that the content of sCD14 (presepsin) is significantly lower in vaccinated individuals, both with low and high CP, compared with donors. When studying the correlations between CP and serum biomarkers in vaccinated individuals, a weak inverse correlation was found for sLBP (r = –0.465) and IL-6 (r = –0.437), as well as an average inverse correlation for sTREM1 (r = –0.508).

Risk of Hospitalization in Under-five Children With Community-Acquired Pneumonia: A Multicentric Prospective Cohort Study

To evaluate factors associated with risk of hospitalization in children with community-acquired pneumonia (CAP). Prospective cohort study. Multi-site hospital based study. A separate acute respiratory tract infection (ARI) treatment unit (ATU) was established. The revised WHO case definition for ARI was used across all the study sites to ensure uniformity in management of ARI patients (2-59 months). Clinical history, examination findings and investigations of enrolled patients were recorded on a predesigned case record form. Children were followed up at 1 week (± 1 day). Risk factors for hospitalization among pneumonia patients. A total of 7026 children with the diagnosis of ARI were enrolled. Pneumonia was diagnosed in 938 (13.4%) patients (median (IQR) age: 15 (8, 25) months; 63.5% boys). Hospitalization was needed in 56.8% of pneumonia patients. On multi-variate analysis, factors associated with risk of hospitalization were: Oxygen saturation on pulse oximetry (SpO2) <92% in room air (OR 7.04; 95% CI 1.6, 30.8, P=0.01), procalcitonin level >0.5 ng/mL (OR: 7.5, 95% CI: 1.0, 57.7, P=0.05), and lower weight for height z-score (OR 0.8; 95% CI: 0.6, 0.9, P=0.02). Present study found SpO2 <92% at room air, serum procalcitonin level >0.5 ng/mL and lower weight for height z-score to be predictors for risk of hospitalization in under-five children presenting with community acquired pneumonia. These factors can be utilized to assess a child with CAP regarding the need of hospitalization.