Procalcitonin Increase Is Associated with the Development of Critical Care-Acquired Infections in COVID-19 ARDS

Secondary bacterial infection in COVID-19 patients is associated with increased mortality and disproportionately affects critically ill patients. This single-centre retrospective observational study investigates the comparative efficacy of change in procalcitonin (PCT) and other commonly available b...

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Autores principales:	Owen Richards, Philip Pallmann, Charles King, Yusuf Cheema, Charlotte Killick, Emma Thomas-Jones, Jessica Harris, Catherine Bailey, Tamas Szakmany
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	COVID-19 procalcitonin C-reactive protein secondary infection Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/81e29d712ba44af68bce49b9540bcb3f
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spelling	oai:doaj.org-article:81e29d712ba44af68bce49b9540bcb3f2021-11-25T16:25:13ZProcalcitonin Increase Is Associated with the Development of Critical Care-Acquired Infections in COVID-19 ARDS10.3390/antibiotics101114252079-6382https://doaj.org/article/81e29d712ba44af68bce49b9540bcb3f2021-11-01T00:00:00Zhttps://www.mdpi.com/2079-6382/10/11/1425https://doaj.org/toc/2079-6382Secondary bacterial infection in COVID-19 patients is associated with increased mortality and disproportionately affects critically ill patients. This single-centre retrospective observational study investigates the comparative efficacy of change in procalcitonin (PCT) and other commonly available biomarkers in revealing or predicting microbiologically proven secondary infection in critical COVID-19 patients. Adult patients admitted to an intensive care unit (ICU) with confirmed SARS-CoV-2 infection between 9 March 2020 and 5 June 2020 were recruited to the study. For daily biomarker and secondary infection, laboratory-confirmed bloodstream infection (LCBI) and ventilator-associated pneumonia/tracheobronchitis (VAP/VAT) data were collected. We observed a PCT rise in 53 (81.5%) of the patients, a C-reactive protein (CRP) rise in 55 (84.6%) and a white blood cell count (WBC) rise in 61 (93.8%). Secondary infection was confirmed in 33 (50.8%) of the patients. A PCT rise was present in 97.0% of patients with at least one confirmed VAP/VAT and/or LCBI event. CRP and WBC rises occurred in 93.9% and 97.0% of patients with confirmed VAP/VAT and/or LCBI, respectively. Logistic regression analysis found that, when including all biomarkers in the same model, there was a significant association between PCT rise and the occurrence of LCBI and/or VAP/VAT (OR = 14.86 95%CI: 2.20, 342.53; <i>p</i> = 0.021). Conversely, no statistically significant relationship was found between either a CRP rise (<i>p</i> = 0.167) or a WBC rise (<i>p</i> = 0.855) and the occurrence of VAP/VAT and/or LCBI. These findings provide a promising insight into the usefulness of PCT measurement in predicting the emergence of secondary bacterial infection in ICU.Owen RichardsPhilip PallmannCharles KingYusuf CheemaCharlotte KillickEmma Thomas-JonesJessica HarrisCatherine BaileyTamas SzakmanyMDPI AGarticleCOVID-19procalcitoninC-reactive proteinsecondary infectionTherapeutics. PharmacologyRM1-950ENAntibiotics, Vol 10, Iss 1425, p 1425 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	COVID-19 procalcitonin C-reactive protein secondary infection Therapeutics. Pharmacology RM1-950
spellingShingle	COVID-19 procalcitonin C-reactive protein secondary infection Therapeutics. Pharmacology RM1-950 Owen Richards Philip Pallmann Charles King Yusuf Cheema Charlotte Killick Emma Thomas-Jones Jessica Harris Catherine Bailey Tamas Szakmany Procalcitonin Increase Is Associated with the Development of Critical Care-Acquired Infections in COVID-19 ARDS
description	Secondary bacterial infection in COVID-19 patients is associated with increased mortality and disproportionately affects critically ill patients. This single-centre retrospective observational study investigates the comparative efficacy of change in procalcitonin (PCT) and other commonly available biomarkers in revealing or predicting microbiologically proven secondary infection in critical COVID-19 patients. Adult patients admitted to an intensive care unit (ICU) with confirmed SARS-CoV-2 infection between 9 March 2020 and 5 June 2020 were recruited to the study. For daily biomarker and secondary infection, laboratory-confirmed bloodstream infection (LCBI) and ventilator-associated pneumonia/tracheobronchitis (VAP/VAT) data were collected. We observed a PCT rise in 53 (81.5%) of the patients, a C-reactive protein (CRP) rise in 55 (84.6%) and a white blood cell count (WBC) rise in 61 (93.8%). Secondary infection was confirmed in 33 (50.8%) of the patients. A PCT rise was present in 97.0% of patients with at least one confirmed VAP/VAT and/or LCBI event. CRP and WBC rises occurred in 93.9% and 97.0% of patients with confirmed VAP/VAT and/or LCBI, respectively. Logistic regression analysis found that, when including all biomarkers in the same model, there was a significant association between PCT rise and the occurrence of LCBI and/or VAP/VAT (OR = 14.86 95%CI: 2.20, 342.53; <i>p</i> = 0.021). Conversely, no statistically significant relationship was found between either a CRP rise (<i>p</i> = 0.167) or a WBC rise (<i>p</i> = 0.855) and the occurrence of VAP/VAT and/or LCBI. These findings provide a promising insight into the usefulness of PCT measurement in predicting the emergence of secondary bacterial infection in ICU.
format	article
author	Owen Richards Philip Pallmann Charles King Yusuf Cheema Charlotte Killick Emma Thomas-Jones Jessica Harris Catherine Bailey Tamas Szakmany
author_facet	Owen Richards Philip Pallmann Charles King Yusuf Cheema Charlotte Killick Emma Thomas-Jones Jessica Harris Catherine Bailey Tamas Szakmany
author_sort	Owen Richards
title	Procalcitonin Increase Is Associated with the Development of Critical Care-Acquired Infections in COVID-19 ARDS
title_short	Procalcitonin Increase Is Associated with the Development of Critical Care-Acquired Infections in COVID-19 ARDS
title_full	Procalcitonin Increase Is Associated with the Development of Critical Care-Acquired Infections in COVID-19 ARDS
title_fullStr	Procalcitonin Increase Is Associated with the Development of Critical Care-Acquired Infections in COVID-19 ARDS
title_full_unstemmed	Procalcitonin Increase Is Associated with the Development of Critical Care-Acquired Infections in COVID-19 ARDS
title_sort	procalcitonin increase is associated with the development of critical care-acquired infections in covid-19 ards
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/81e29d712ba44af68bce49b9540bcb3f
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Procalcitonin Increase Is Associated with the Development of Critical Care-Acquired Infections in COVID-19 ARDS

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