ArticleThe Journal of infection2022
Negative predictive value of procalcitonin to rule out bacterial respiratory co-infection in critical covid-19 patients.
Article in The Journal of infection, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 41 citations in OpenAlex.
- Prognostic value of C-reactive protein levels in pulmonary infections: A systematic review and meta-analysis.Medicine · 2025Pooled it
- Post-COVID Respiratory Sequelae in COPD: Mucus Plugging, Infectious Complications, and Risk-Stratified Follow-Up.Journal of clinical medicine · 2026Review
- Does Empirical Antibiotic Use Improve Outcomes in Ventilated Patients with Pandemic Viral Infection? A Multicentre Retrospective Study.Antibiotics (Basel, Switzerland) · 2025Article
- Clinical management of sepsis-associated acute respiratory distress syndrome: current evidence and future directions.Frontiers in medicine · 2025Review
- Correlation Between Inflammatory Markers and Pathogenic Bacteria in Children's Winter Respiratory Infections in Xinjiang.International journal of general medicine · 2025Article
- A Machine Learning Approach to Determine Risk Factors for Respiratory Bacterial/Fungal Coinfection in Critically Ill Patients with Influenza and SARS-CoV-2 Infection: A Spanish Perspective.Antibiotics (Basel, Switzerland) · 2024Article
- The long Pentraxin PTX3 serves as an early predictive biomarker of co-infections in COVID-19.EBioMedicine · 2024Article
- Evaluation of Serial Procalcitonin Levels for the Optimization of Antibiotic Use in Non-Critically Ill COVID-19 Patients.Pharmaceuticals (Basel, Switzerland) · 2024Article
- Critically ill children with SARS-COV-2 Omicron infection at a national children medical center, Guangdong, China.BMC pediatrics · 2024Article
- Article
- Risk factors, outcomes, and epidemiological and etiological study of hospitalized COVID-19 patients with bacterial co-infection and secondary infections.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2024Article
- Bacterial infections in patients with COVID-19: the impact of procalcitonin testing on antibiotics prescription in the real world.BMC infectious diseases · 2024Article
- Are C-reactive protein and procalcitonin safe and useful for antimicrobial stewardship purposes in patients with COVID-19? A scoping review.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2024Article
- [Bacterial coinfection in the critically-ill COVID-19 patient: incidence, impact and need for antimicrobial therapy].Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2023Article
- A high α1-antitrypsin/interleukin-10 ratio predicts bacterial pneumonia in adults with community-acquired pneumonia: a prospective cohort study.Pneumonia (Nathan Qld.) · 2023Article
- The Association of Procalcitonin and C-Reactive Protein with Bacterial Infections Acquired during Intensive Care Unit Stay in COVID-19 Critically Ill Patients.Antibiotics (Basel, Switzerland) · 2023Article
- COVID-19 Biomarkers for Critically Ill Patients: A Compendium for the Physician.Neurology international · 2023Review
- An Observational Study to Develop a Predictive Model for Bacterial Pneumonia Diagnosis in Severe COVID-19 Patients-C19-PNEUMOSCORE.Journal of clinical medicine · 2023Article
- Antibiotic Prescription in Patients With Coronavirus Disease 2019: Analysis of National Health Insurance System Data in the Republic of Korea.Journal of Korean medical science · 2023Article
- Understanding how diagnostics influence antimicrobial decision-making is key to successful clinical trial design.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2023Article
Corrections and comments
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Authors and funding
35 authors at 20 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundProcalcitonin (PCT) and C-Reactive Protein (CRP) are useful biomarkers to differentiate bacterial from viral or fungal infections, although the association between them and co-infection or mortality in COVID-19 remains unclear.
methodsThe study represents a retrospective cohort study of patients admitted for COVID-19 pneumonia to 84 ICUs from ten countries between (March 2020-January 2021). Primary outcome was to determine whether PCT or CRP at admission could predict community-acquired bacterial respiratory co-infection (BC) and its added clinical value by determining the best discriminating cut-off values. Secondary outcome was to investigate its association with mortality. To evaluate the main outcome, a binary logistic regression was performed. The area under the curve evaluated diagnostic performance for BC prediction.
results4635 patients were included, 7.6% fulfilled BC diagnosis. PCT (0.25[IQR 0.1-0.7] versus 0.20[IQR 0.1-0.5]ng/mL, p<0.001) and CRP (14.8[IQR 8.2-23.8] versus 13.3 [7-21.7]mg/dL, p=0.01) were higher in BC group. Neither PCT nor CRP were independently associated with BC and both had a poor ability to predict BC (AUC for PCT 0.56, for CRP 0.54). Baseline values of PCT<0.3ng/mL, could be helpful to rule out BC (negative predictive value 91.1%) and PCT≥0.50ng/mL was associated with ICU mortality (OR 1.5,p<0.001).
conclusionsThese biomarkers at ICU admission led to a poor ability to predict BC among patients with COVID-19 pneumonia. Baseline values of PCT<0.3ng/mL may be useful to rule out BC, providing clinicians a valuable tool to guide antibiotic stewardship and allowing the unjustified overuse of antibiotics observed during the pandemic, additionally PCT≥0.50ng/mL might predict worsening outcomes.
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