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Prognostic Value of Procalcitonin and C-Reactive Protein in 1608 Critically Ill Patients with Severe Influenza Pneumonia

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 o...

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Autores principales: Carbonell, Raquel, Moreno, Gerard, Martín-Loeches, 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8066504/
https://www.ncbi.nlm.nih.gov/pubmed/33810263
http://dx.doi.org/10.3390/antibiotics10040350
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author Carbonell, Raquel
Moreno, Gerard
Martín-Loeches, 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
author_facet Carbonell, Raquel
Moreno, Gerard
Martín-Loeches, 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
author_sort Carbonell, Raquel
collection PubMed
description 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.
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spelling pubmed-80665042021-04-25 Prognostic Value of Procalcitonin and C-Reactive Protein in 1608 Critically Ill Patients with Severe Influenza Pneumonia Carbonell, Raquel Moreno, Gerard Martín-Loeches, 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 Antibiotics (Basel) Article 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. MDPI 2021-03-26 /pmc/articles/PMC8066504/ /pubmed/33810263 http://dx.doi.org/10.3390/antibiotics10040350 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ).
spellingShingle Article
Carbonell, Raquel
Moreno, Gerard
Martín-Loeches, 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
Prognostic Value of Procalcitonin and C-Reactive Protein in 1608 Critically Ill Patients with Severe Influenza Pneumonia
title Prognostic Value of Procalcitonin and C-Reactive Protein in 1608 Critically Ill Patients with Severe Influenza Pneumonia
title_full Prognostic Value of Procalcitonin and C-Reactive Protein in 1608 Critically Ill Patients with Severe Influenza Pneumonia
title_fullStr Prognostic Value of Procalcitonin and C-Reactive Protein in 1608 Critically Ill Patients with Severe Influenza Pneumonia
title_full_unstemmed Prognostic Value of Procalcitonin and C-Reactive Protein in 1608 Critically Ill Patients with Severe Influenza Pneumonia
title_short Prognostic Value of Procalcitonin and C-Reactive Protein in 1608 Critically Ill Patients with Severe Influenza Pneumonia
title_sort prognostic value of procalcitonin and c-reactive protein in 1608 critically ill patients with severe influenza pneumonia
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8066504/
https://www.ncbi.nlm.nih.gov/pubmed/33810263
http://dx.doi.org/10.3390/antibiotics10040350
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