Citations 1
Role of Procalcitonin as a Prognostic Biomarker in Hospitalized COVID-19 Patients: A Comparative Analysis
Raavi, Lekhya , Jonna, Sadhana , NATARAJA, HRISHIKESH , Craver, Emily C. , Jenkins, Anna , Hanson, Abby , Balasubramanian, Prasanth , Tekin, Aysun, Bansal, Vikas , Reddy, Swetha , Caples, Sean M., Khan, Syed Anjum , Jain, Nitesh , LaNou, Abigail T. , Cartin‐Ceba, Rodrigo , Milian, Ricardo Diaz , Venegas, Carla , Shapiro, Anna B, Kiley, Sean , Quiñones, Quintin J., Patel, Neal M. , Roy, Archana , Sanghavi, Devang , Isha, Shahin , Hanson, Abby J, Balavenkataraman, Arvind , Bansal, Vikas , Jain, Nitesh K, Diaz Milian, Ricardo , Venegas, Carla P, Chaudhary, Sanjay , Kiley, Sean P, Roy, Archana , Sanghavi, Devang K., Jenkins, Anna, Tekin, Aysun , Kashyap, Rahul , Bhattacharyya, Anirban, Chaudhary, Sanjay , Guru, Pramod , Franco, Pablo Moreno
Biomarker Insights | May 16, 2025 | Volume: 20 | Issue: No issue available | Pages: No page available
Background: Procalcitonin (PCT) is recognized as an inflammatory biomarker, often elevated in COVID-19 pneumonia alongside other biomarkers. Understanding its association with severe outcomes and comparing its predictive ability with other biomarkers is crucial for clinical management. Objectives: This retrospective multicenter observational study aimed to investigate the association between PCT levels and adverse outcomes in hospitalized COVID-19 patients. Additionally, it sought to compare the predictive performance of various biomarkers. Design: The study analyzed data from the Society of Critical Care Medicine (SCCM) Viral Infection and Respiratory Illness Universal Study (VIRUS) registry, comprising COVID-19 patients hospitalized across multiple Mayo Clinic sites between March 2020 and June 2022. Methods: A total of 7851 adult COVID-19 patients were included. Patients were categorized into 6 groups based on the worst WHO ordinal scale. Multivariate models were constructed using peak biomarker levels within 72 hours of admission, adjusted for confounders. Results: Elevated PCT levels were independently associated with increased odds of adverse outcomes, including ICU admission (adjusted odds ratio [aOR] 1.32, 95%CI 1.27-1.38), IMV requirement (aOR 1.35, 95%CI: 1.28-1.42), and in-hospital mortality (aOR 1.30, 95%CI: 1.22-1.37). A 3.48-fold increase in IMV requirement and 3.55 times increase in in-hospital mortality were noted with peak PCT ⩾ 0.25 ng/ml. Similar associations were observed with other biomarkers like NLR (AUC 0.730), CRP, IL-6, LDH (AUC 0.800), and D-dimer (AUC 0.719). Models incorporating NLR, LDH, D-dimer, and PCT demonstrated the highest predictive accuracy, with a combined model exhibiting an area under the curve (AUC) of 0.826 (95%CI 0.803-0.849). Conclusions: Higher PCT levels were significantly linked to worse outcomes in COVID-19 patients, emphasizing its potential as a prognostic marker. Biomarker-based predictive models, particularly those including PCT, showed promising utility for risk assessment and clinical decision-making. Further prospective studies are warranted to validate these findings on a larger scale.