C-reactive protein and procalcitonin for antimicrobial stewardship in COVID-19

• DOI: 10.1007/s15010-021-01615-8
• Publication Date: 2021-05-22T12:02:57Z
• Authors: Isabell Pink; David Raupach; Jan Fuge; Ralf-Peter Vonberg; Marius M. Hoeper; Tobias Welte; Jessica Rademacher
• Keywords: Procalcitonin; Antimicrobial Stewardship

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory coronavirus 2 (SARS-CoV-2) has spread around the world. Differentiation between pure viral COVID-19 pneumonia and secondary infection can be challenging. In patients with elevated C-reactive protein (CRP) on admission physicians often decide to prescribe antibiotic therapy. However, overuse of anti-infective therapy in pandemic should avoided prevent increasing antimicrobial resistance. Procalcitonin (PCT) CRP have proven useful other lower tract infections might help differentiate or infection.We performed a retrospective study admitted 6th March 30th October 2020. Patient background, clinical course, laboratory findings focus PCT levels microbiology results were evaluated. Patients without bacterial relation compared. Using receiver operating characteristic (ROC) analysis, best discriminating cut-off value corresponding sensitivity specificity was calculated.Out 99 inpatients (52 ICU, 47 Non-ICU) COVID-19, 32 (32%) presented during hospitalization. had higher (0.4 versus 0.1 ng/mL; p = 0.016) (131 73 mg/L; 0.001) at hospital stay (2.9 < 0.001 resp. 293 94 0.001). The majority general ward no (93%). More than half ICU developed (56%). ROC analysis highest yielded AUCs 0.88 (p 0.86 for entire cohort. With 0.55 ng/mL, 91% 81%; 172 mg/L 81% 76%.PCT measurement course may helpful identifying guiding use