Procalcitonin increase is associated with the development of critical care-acquired infections in COVID-19 ARDS

Richards, Owen, Pallmann, Philip ORCID: https://orcid.org/0000-0001-8274-9696, King, Charles, Cheema, Yusuf, Killick, Charlotte, Thomas-Jones, Emma ORCID: https://orcid.org/0000-0001-7716-2786, Harris, Jessica, Bailey, Catherine and Szakmany, Tamas ORCID: https://orcid.org/0000-0003-3632-8844 2021. Procalcitonin increase is associated with the development of critical care-acquired infections in COVID-19 ARDS. Antibiotics 10 (11) , 1425. 10.3390/antibiotics10111425

Preview

PDF - Published Version Available under License Creative Commons Attribution. Download (780kB) | Preview

Abstract

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; p = 0.021). Conversely, no statistically significant relationship was found between either a CRP rise (p = 0.167) or a WBC rise (p = 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.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine Centre for Trials Research (CNTRR)
Additional Information:	This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.
Publisher:	MDPI
ISSN:	2079-6382
Date of First Compliant Deposit:	1 December 2021
Date of Acceptance:	17 November 2021
Last Modified:	07 Nov 2023 02:43
URI:	https://orca.cardiff.ac.uk/id/eprint/145656

Citation Data

Cited 9 times in Scopus. View in Scopus. Powered By Scopus® Data

Actions (repository staff only)

Edit Item