Prognostic Value of Procalcitonin and C-Reactive Protein in 1608 Critically Ill Patients with Severe Influenza Pneumonia.
Authors
Carbonell, RaquelMoreno, Gerard
martin-loeches, Prof. Ignacio
Gomez-Bertomeu, Frederic
Sarvisé, Carolina
Gómez, Josep
Bodí, María
Díaz, Emili
Papiol, Elisabeth
Trefler, Sandra
Nieto, Mercedes
Estella, Angel
Jiménez Herrera, María
Vidal Cortés, Pablo
Guardiola, Juan José
Solé-Violán, Jordi
Rodríguez, Alejandro
Issue Date
2021-03-26Keywords
C-reactive proteinGram negative bacilli
Gram-positive cocci
MORTALITY
PNEUMONIA
procalcitonin
Metadata
Show full item recordJournal
Antibiotics (Basel, Switzerland)DOI
10.3390/antibiotics10040350PubMed ID
33810263Abstract
Background: Procalcitonin (PCT) and C-Reactive protein (CRP) are well-established sepsis biomarkers. The association of baseline PCT levels and mortality in pneumonia remains unclear, and we still do not know whether biomarkers levels could be related to the causative microorganism (GPC, GNB). The objective of this study is to address these issues. Methods: a retrospective observational cohort study was conducted in 184 Spanish ICUs (2009-2018). Results: 1608 patients with severe influenza pneumonia with PCT and CRP available levels on admission were included, 1186 with primary viral pneumonia (PVP) and 422 with bacterial Co-infection (BC). Those with BC presented higher PCT levels (4.25 [0.6-19.5] versus 0.6 [0.2-2.3]ng/mL) and CRP (36.7 [20.23-118] versus 28.05 [13.3-109]mg/dL) as compared to PVP (p < 0.001). Deceased patients had higher PCT (ng/mL) when compared with survivors, in PVP (0.82 [0.3-2.8]) versus 0.53 [0.19-2.1], p = 0.001) and BC (6.9 [0.93-28.5] versus 3.8 [0.5-17.37], p = 0.039). However, no significant association with mortality was observed in the multivariate analysis. The PCT levels (ng/mL) were significantly higher in polymicrobial infection (8.4) and GPC (6.9) when compared with GNB (1.2) and Aspergillus (1.7). The AUC-ROC of PCT for GPC was 0.67 and 0.32 for GNB. The AUROC of CRP was 0.56 for GPC and 0.39 for GNB. Conclusions: a single PCT/CRP value at ICU admission was not associated with mortality in severe influenza pneumonia. None of the biomarkers have enough discriminatory power to be used for predicting the causative microorganism of the co-infection.Item Type
ArticleLanguage
enISSN
2079-6382ae974a485f413a2113503eed53cd6c53
10.3390/antibiotics10040350
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