PROCALCITONIN AS A PREDICTOR OF CLINICAL OUTCOMES IN PATIENTS WITH COVID-19

Jackson, Ian; Jaradeh, Hadi; Aurit, Sarah; Aldamen, Ali; Narechania, Shraddha; Destache, Chris; Velagapudi, Manasa

TOPIC: Chest Infections TYPE: Original Investigations PURPOSE: The purpose of this study was to retrospectively determine if elevated procalcitonin (PCT) in patients hospitalized with COVID-19 was associated with increased in-hospital mortality, intensive care unit (ICU) length of stay, or hospital length of stay. METHODS: We collected data on 402 adult patients with positive COVID-19 PCR testing admitted to hospitals within our health system from March 1, 2020 until July 10, 2020. Patient characteristics including age, tobacco use, coronary artery disease, hypertension, chronic kidney disease, malignancy, vital signs on admission, PCT levels upon admission, peak PCT levels, and CT chest results were collected. Clinical outcomes including hospital length of stay, ICU length of stay, and in-hospital mortality were also obtained. A PCT measurement on admission of 0.25 ng/mL was used to stratify patients into two mutually exclusive groups. Comparisons of the two groups were made with Mann-Whitney for continuous variables and Chi-square or Fisher’s exact test based on expected frequencies. Multivariable binary logistic regression models were used to model mortality. Kaplan-Meier was used to examine potential differences in overall length of stay as well as ICU length of stay while considering death to be a censoring event. SAS v. 9.4 was used for all analyses;P < 0.05 was deemed significant. RESULTS: Results of the multivariable analysis demonstrated elevated PCT level on hospital admission was not associated with increased odds of mortality (OR = 1.00;95% Cl: 0.97 to 1.02;P = 0.713). Results of the Kaplan-Meier curve revealed no evidence of a significant difference between PCT groups for hospital length of stay (P = 0.144) or ICU length of stay (P = 0.260). Results from the mortality model demonstrated every additional ten years of age was associated with increased odds of mortality (OR = 2.42;95% CI: 1.59 to 4.09;P < 0.001) after adjusting for all other variables. Increased duration of mechanical ventilation was also associated with increased odds of mortality (OR = 2.67;95% CI: 1.52 to 5.10;P = 0.001). CONCLUSIONS: This retrospective study of patients hospitalized with COVID-19 demonstrated no evidence that elevated PCT levels on hospital admission were associated with increased in-hospital mortality, ICU length of stay, or hospital length of stay. CLINICAL IMPLICATIONS: Further studies are needed to fully assess the use of PCT in COVID-19 patients as a prognostic biomarker to predict mortality and other clinical outcomes. DISCLOSURES: No relevant relationships by Ali Aldamen, source=Web Response No relevant relationships by Sarah Aurit, source=Web Response No relevant relationships by Chris Destache, source=Web Response No relevant relationships by Ian Jackson, source=Web Response No relevant relationships by Hadi Jaradeh, source=Web Response No relevant relationships by Shraddha Narechania, source=Web Response No relevant relationships by Manasa Velagapudi, source=Web Response