ESCMID eAcademy

ePosters are only viewable by those with a valid ECCMID 2021 registration.
If you already have a registration, please login to the online platform here.
If you are not yet registered, you can do so here.
Abstract
Discussion Forum (0)
Abstract number: 2709

Session Type: ePosters

Session Title: ePosters

Authors(s): W. So (1), C. Kubin (2), J. Choi (3), T. Wang (4), S. Williams (5), M. Simon (6)

Authors Affiliations(s): (1) Long Island University, New York Presbyterian Weill Cornell Medical Center, United States, (2) New York Presbyterian-Columbia University Medical Center, United States, (3) Dept of medicine, Weill Cornell Medicine, United States, (4) Dept of medicine, division of ID, Columbia Universitye, United States, (5) Weill Cornell-MSKCC-Rockefeller University Tri Institutional MD-PhD Program, United States, (6) Dept of medicine, division of ID, Weill Cornell Medicine, United States

Background:

Elevated procalcitonin (PCT) has been reported to be a predictor of severe disease in COVID-19. However, it is unknown if PCT increase is driven by bacterial co-infection or severity of COVID-19. We compared baseline and peak PCT in patients with COVID-19 with and without bacterial co-infections and described the factors associated with PCT≥0.25µg/L.

Methods:

Retrospective chart reviews were performed in adult patients hospitalized with SARS-CoV-2 (+) by RT-PCR during March-May 2020. We excluded patients with renal disease, any extrapulmonary infection without pathogen isolated, and hospital transfers. Bacterial co-infections were from any body site and defined as proven (microbiologically confirmed), low-suspicion (pulmonary infiltrates compatible with viral pneumonia without other infectious source) or absent (no radiographic pulmonary infiltrates). Baseline-PCT (<24hours of hospitalization) and peak-PCT (<14days of hospitalization) were compared between absent/low-suspicion and proven bacterial co-infections stratified by admission to an intensive care unit (ICU). Factors including ICU admission, antibiotic use and bacterial co-infections were assessed in multivariable analyses in association with PCT≥0.25µg/L.

Results:

From 1315 hospitalized patients with COVID-19 and available PCTs, 924 non-ICU and 103 ICU patients were included in baseline-PCT population; peak-PCTs were available in 307 non-ICU and 236 ICU patients (Table 1). The rates of proven bacterial co-infections were higher in ICU v. non-ICU: 7.8% (ICU) v. 3.5% (non-ICU) for baseline-PCT (p=0.042) and 26.3% (ICU) v. 5.5% (non-ICU) for peak-PCT (p<0.001). PCTs showed a wide range of distribution regardless of bacterial co-infections (Table 1, Figure 1). Sensitivity/Specificity/PPV/NPV was 69/65/6.5/98% (Non-ICU) and 75/33/8.6/94% (ICU) for baseline-PCT≥0.25µg/L and 82/35/6.9/97% (Non-ICU) and 65/75/13/97% (ICU) for peak-PCT≥0.25µg/L. The most common co-infections at baseline were bacteremia (n=14) and genitourinary infections (n=12) in non-ICU, and bacteremia (n=4) and pneumonia (n=3) in ICU (Figure 2). Baseline/peak-PCT≥0.25µg/L were significantly associated with ICU admission (OR 2.371, p<0.001/OR 5.685, p<0.001) and antibiotic-use (OR 4.017, p<0.001/ OR 2.717, p<0.001) but not with bacterial co-infections (OR 1.306, p=0.413/OR 0.845, p=0.719). 

Conclusions:

PCT cutoff of 0.25µg/L showed poor PPV and high NPV for proven bacterial co-infections. Given the wide distribution of PCTs regardless of confirmed bacterial co-infection, elevated PCTs in COVID-19 is unlikely to reliably distinguish patients with bacterial co-infections.  

Keyword(s): Procalcitonin, Bacterial co-infections, COVID-19

Abstract number: 2709

Session Type: ePosters

Session Title: ePosters

Authors(s): W. So (1), C. Kubin (2), J. Choi (3), T. Wang (4), S. Williams (5), M. Simon (6)

Authors Affiliations(s): (1) Long Island University, New York Presbyterian Weill Cornell Medical Center, United States, (2) New York Presbyterian-Columbia University Medical Center, United States, (3) Dept of medicine, Weill Cornell Medicine, United States, (4) Dept of medicine, division of ID, Columbia Universitye, United States, (5) Weill Cornell-MSKCC-Rockefeller University Tri Institutional MD-PhD Program, United States, (6) Dept of medicine, division of ID, Weill Cornell Medicine, United States

Background:

Elevated procalcitonin (PCT) has been reported to be a predictor of severe disease in COVID-19. However, it is unknown if PCT increase is driven by bacterial co-infection or severity of COVID-19. We compared baseline and peak PCT in patients with COVID-19 with and without bacterial co-infections and described the factors associated with PCT≥0.25µg/L.

Methods:

Retrospective chart reviews were performed in adult patients hospitalized with SARS-CoV-2 (+) by RT-PCR during March-May 2020. We excluded patients with renal disease, any extrapulmonary infection without pathogen isolated, and hospital transfers. Bacterial co-infections were from any body site and defined as proven (microbiologically confirmed), low-suspicion (pulmonary infiltrates compatible with viral pneumonia without other infectious source) or absent (no radiographic pulmonary infiltrates). Baseline-PCT (<24hours of hospitalization) and peak-PCT (<14days of hospitalization) were compared between absent/low-suspicion and proven bacterial co-infections stratified by admission to an intensive care unit (ICU). Factors including ICU admission, antibiotic use and bacterial co-infections were assessed in multivariable analyses in association with PCT≥0.25µg/L.

Results:

From 1315 hospitalized patients with COVID-19 and available PCTs, 924 non-ICU and 103 ICU patients were included in baseline-PCT population; peak-PCTs were available in 307 non-ICU and 236 ICU patients (Table 1). The rates of proven bacterial co-infections were higher in ICU v. non-ICU: 7.8% (ICU) v. 3.5% (non-ICU) for baseline-PCT (p=0.042) and 26.3% (ICU) v. 5.5% (non-ICU) for peak-PCT (p<0.001). PCTs showed a wide range of distribution regardless of bacterial co-infections (Table 1, Figure 1). Sensitivity/Specificity/PPV/NPV was 69/65/6.5/98% (Non-ICU) and 75/33/8.6/94% (ICU) for baseline-PCT≥0.25µg/L and 82/35/6.9/97% (Non-ICU) and 65/75/13/97% (ICU) for peak-PCT≥0.25µg/L. The most common co-infections at baseline were bacteremia (n=14) and genitourinary infections (n=12) in non-ICU, and bacteremia (n=4) and pneumonia (n=3) in ICU (Figure 2). Baseline/peak-PCT≥0.25µg/L were significantly associated with ICU admission (OR 2.371, p<0.001/OR 5.685, p<0.001) and antibiotic-use (OR 4.017, p<0.001/ OR 2.717, p<0.001) but not with bacterial co-infections (OR 1.306, p=0.413/OR 0.845, p=0.719). 

Conclusions:

PCT cutoff of 0.25µg/L showed poor PPV and high NPV for proven bacterial co-infections. Given the wide distribution of PCTs regardless of confirmed bacterial co-infection, elevated PCTs in COVID-19 is unlikely to reliably distinguish patients with bacterial co-infections.  

Keyword(s): Procalcitonin, Bacterial co-infections, COVID-19

Characteristics of procalcitonin in hospitalised patients with COVID-19 based on bacterial co-infections
Wonhee So
Wonhee So
ESCMID eAcademy. So W. 07/09/2021; 328899; 2709
user
Wonhee So
Abstract
Discussion Forum (0)
Abstract number: 2709

Session Type: ePosters

Session Title: ePosters

Authors(s): W. So (1), C. Kubin (2), J. Choi (3), T. Wang (4), S. Williams (5), M. Simon (6)

Authors Affiliations(s): (1) Long Island University, New York Presbyterian Weill Cornell Medical Center, United States, (2) New York Presbyterian-Columbia University Medical Center, United States, (3) Dept of medicine, Weill Cornell Medicine, United States, (4) Dept of medicine, division of ID, Columbia Universitye, United States, (5) Weill Cornell-MSKCC-Rockefeller University Tri Institutional MD-PhD Program, United States, (6) Dept of medicine, division of ID, Weill Cornell Medicine, United States

Background:

Elevated procalcitonin (PCT) has been reported to be a predictor of severe disease in COVID-19. However, it is unknown if PCT increase is driven by bacterial co-infection or severity of COVID-19. We compared baseline and peak PCT in patients with COVID-19 with and without bacterial co-infections and described the factors associated with PCT≥0.25µg/L.

Methods:

Retrospective chart reviews were performed in adult patients hospitalized with SARS-CoV-2 (+) by RT-PCR during March-May 2020. We excluded patients with renal disease, any extrapulmonary infection without pathogen isolated, and hospital transfers. Bacterial co-infections were from any body site and defined as proven (microbiologically confirmed), low-suspicion (pulmonary infiltrates compatible with viral pneumonia without other infectious source) or absent (no radiographic pulmonary infiltrates). Baseline-PCT (<24hours of hospitalization) and peak-PCT (<14days of hospitalization) were compared between absent/low-suspicion and proven bacterial co-infections stratified by admission to an intensive care unit (ICU). Factors including ICU admission, antibiotic use and bacterial co-infections were assessed in multivariable analyses in association with PCT≥0.25µg/L.

Results:

From 1315 hospitalized patients with COVID-19 and available PCTs, 924 non-ICU and 103 ICU patients were included in baseline-PCT population; peak-PCTs were available in 307 non-ICU and 236 ICU patients (Table 1). The rates of proven bacterial co-infections were higher in ICU v. non-ICU: 7.8% (ICU) v. 3.5% (non-ICU) for baseline-PCT (p=0.042) and 26.3% (ICU) v. 5.5% (non-ICU) for peak-PCT (p<0.001). PCTs showed a wide range of distribution regardless of bacterial co-infections (Table 1, Figure 1). Sensitivity/Specificity/PPV/NPV was 69/65/6.5/98% (Non-ICU) and 75/33/8.6/94% (ICU) for baseline-PCT≥0.25µg/L and 82/35/6.9/97% (Non-ICU) and 65/75/13/97% (ICU) for peak-PCT≥0.25µg/L. The most common co-infections at baseline were bacteremia (n=14) and genitourinary infections (n=12) in non-ICU, and bacteremia (n=4) and pneumonia (n=3) in ICU (Figure 2). Baseline/peak-PCT≥0.25µg/L were significantly associated with ICU admission (OR 2.371, p<0.001/OR 5.685, p<0.001) and antibiotic-use (OR 4.017, p<0.001/ OR 2.717, p<0.001) but not with bacterial co-infections (OR 1.306, p=0.413/OR 0.845, p=0.719). 

Conclusions:

PCT cutoff of 0.25µg/L showed poor PPV and high NPV for proven bacterial co-infections. Given the wide distribution of PCTs regardless of confirmed bacterial co-infection, elevated PCTs in COVID-19 is unlikely to reliably distinguish patients with bacterial co-infections.  

Keyword(s): Procalcitonin, Bacterial co-infections, COVID-19

Abstract number: 2709

Session Type: ePosters

Session Title: ePosters

Authors(s): W. So (1), C. Kubin (2), J. Choi (3), T. Wang (4), S. Williams (5), M. Simon (6)

Authors Affiliations(s): (1) Long Island University, New York Presbyterian Weill Cornell Medical Center, United States, (2) New York Presbyterian-Columbia University Medical Center, United States, (3) Dept of medicine, Weill Cornell Medicine, United States, (4) Dept of medicine, division of ID, Columbia Universitye, United States, (5) Weill Cornell-MSKCC-Rockefeller University Tri Institutional MD-PhD Program, United States, (6) Dept of medicine, division of ID, Weill Cornell Medicine, United States

Background:

Elevated procalcitonin (PCT) has been reported to be a predictor of severe disease in COVID-19. However, it is unknown if PCT increase is driven by bacterial co-infection or severity of COVID-19. We compared baseline and peak PCT in patients with COVID-19 with and without bacterial co-infections and described the factors associated with PCT≥0.25µg/L.

Methods:

Retrospective chart reviews were performed in adult patients hospitalized with SARS-CoV-2 (+) by RT-PCR during March-May 2020. We excluded patients with renal disease, any extrapulmonary infection without pathogen isolated, and hospital transfers. Bacterial co-infections were from any body site and defined as proven (microbiologically confirmed), low-suspicion (pulmonary infiltrates compatible with viral pneumonia without other infectious source) or absent (no radiographic pulmonary infiltrates). Baseline-PCT (<24hours of hospitalization) and peak-PCT (<14days of hospitalization) were compared between absent/low-suspicion and proven bacterial co-infections stratified by admission to an intensive care unit (ICU). Factors including ICU admission, antibiotic use and bacterial co-infections were assessed in multivariable analyses in association with PCT≥0.25µg/L.

Results:

From 1315 hospitalized patients with COVID-19 and available PCTs, 924 non-ICU and 103 ICU patients were included in baseline-PCT population; peak-PCTs were available in 307 non-ICU and 236 ICU patients (Table 1). The rates of proven bacterial co-infections were higher in ICU v. non-ICU: 7.8% (ICU) v. 3.5% (non-ICU) for baseline-PCT (p=0.042) and 26.3% (ICU) v. 5.5% (non-ICU) for peak-PCT (p<0.001). PCTs showed a wide range of distribution regardless of bacterial co-infections (Table 1, Figure 1). Sensitivity/Specificity/PPV/NPV was 69/65/6.5/98% (Non-ICU) and 75/33/8.6/94% (ICU) for baseline-PCT≥0.25µg/L and 82/35/6.9/97% (Non-ICU) and 65/75/13/97% (ICU) for peak-PCT≥0.25µg/L. The most common co-infections at baseline were bacteremia (n=14) and genitourinary infections (n=12) in non-ICU, and bacteremia (n=4) and pneumonia (n=3) in ICU (Figure 2). Baseline/peak-PCT≥0.25µg/L were significantly associated with ICU admission (OR 2.371, p<0.001/OR 5.685, p<0.001) and antibiotic-use (OR 4.017, p<0.001/ OR 2.717, p<0.001) but not with bacterial co-infections (OR 1.306, p=0.413/OR 0.845, p=0.719). 

Conclusions:

PCT cutoff of 0.25µg/L showed poor PPV and high NPV for proven bacterial co-infections. Given the wide distribution of PCTs regardless of confirmed bacterial co-infection, elevated PCTs in COVID-19 is unlikely to reliably distinguish patients with bacterial co-infections.  

Keyword(s): Procalcitonin, Bacterial co-infections, COVID-19

By clicking “Accept Terms & all Cookies” or by continuing to browse, you agree to the storing of third-party cookies on your device to enhance your user experience and agree to the user terms and conditions of this learning management system (LMS).

Cookie Settings
Accept Terms & all Cookies