Elucidating the role of procalcitonin as a biomarker in hospitalized COVID-19 patients

Kelsie Cowman, James Rossi, Inessa Gendlina, Yi Guo, Sichen Liu, Wendy Szymczak, Stefanie K. Forest, Lucia Wolgast, Erika Orner, Hongkai Bao, Miguel E. Cervera-Hernandez, Ashley G. Ceniceros, Raja Thota, Liise anne Pirofski, Priya Nori

Research output: Contribution to journalArticlepeer-review

Abstract

Our objectives were to evaluate the role of procalcitonin in identifying bacterial co-infections in hospitalized COVID-19 patients and quantify antibiotic prescribing during the 2020 pandemic surge. Hospitalized COVID-19 patients with both a procalcitonin test and blood or respiratory culture sent on admission were included in this retrospective study. Confirmed co-infection was determined by an infectious diseases specialist. In total, 819 patients were included; 335 (41%) had an elevated procalcitonin (>0.5 ng/mL) and of these, 42 (13%) had an initial bacterial co-infection. Positive predictive value of elevated procalcitonin for co-infection was 13% while the negative predictive value was 94%. Ninety-six percent of patients with an elevated procalcitonin received antibiotics (median 6 days of therapy), compared to 82% with low procalcitonin (median 4 days of therapy) (adjusted OR:3.3, P < 0.001). We observed elevated initial procalcitonin in many COVID patients without concurrent bacterial co-infections which potentially contributed to antibiotic over-prescribing.

Original languageEnglish (US)
Article number115721
JournalDiagnostic Microbiology and Infectious Disease
Volume103
Issue number4
DOIs
StatePublished - Aug 2022

Keywords

  • Antimicrobial stewardship
  • Bacterial co-infection
  • COVID-19
  • Procalcitonin

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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