Titre
Procalcitonina es superior a recuento linfocitario, índice neutrófilo/linfocito y proteína C reactiva para la predicción de mortalidad a 30 días de pacientes con COVID-19 en el servicio de urgencias = Procalcitonin concentration in the emergency department predicts 30-day mortality in COVID-19 better than the lymphocyte count, the neutrophil-tolymphocyte ratio, or the C-reactive protein level.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Emergencias
Auteur(s)
López-Ayala, P.
Auteure/Auteur
Alcaraz-Serna, A.
Auteure/Auteur
Valls Carbó, A.
Auteure/Auteur
Cuadrado Cenzual, M.Á.
Auteure/Auteur
Torrejón Martínez, M.J.
Auteure/Auteur
López Picado, A.
Auteure/Auteur
Martínez Valero, C.
Auteure/Auteur
Miranda, J.D.
Auteure/Auteur
Díaz Del Arco, C.
Auteure/Auteur
Cozar López, G.
Auteure/Auteur
Suárez-Cadenas, MDM
Auteure/Auteur
Jerez Fernández, P.
Auteure/Auteur
Angós, B.
Auteure/Auteur
Rodríguez Adrada, E.
Auteure/Auteur
Cardassay, E.
Auteure/Auteur
Del Toro, E.
Auteure/Auteur
Chaparro, D.
Auteure/Auteur
Montalvo Moraleda, M.T.
Auteure/Auteur
Espejo Paeres, C.
Auteure/Auteur
García Briñón, M.Á.
Auteure/Auteur
Hernández Martín-Romo, V.
Auteure/Auteur
Ortega, L.
Auteure/Auteur
Fernández Pérez, C.
Auteure/Auteur
Martínez-Novillo, M.
Auteure/Auteur
González Armengol, J.J.
Auteure/Auteur
González Del Castillo, J.
Auteure/Auteur
Mueller, C.E.
Auteure/Auteur
Martín-Sánchez, F.J.
Auteure/Auteur
Groupes de travail
IdISSC-COVID-TASKFORCE and COVID-19_URG-HCSC Register investigators
Liens vers les personnes
Liens vers les unités
ISSN
2386-5857
Statut éditorial
Publié
Date de publication
2022-04
Volume
34
Numéro
2
Première page
119
Dernière page/numéro d’article
127
Peer-reviewed
Oui
Langue
anglais
espagnol
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Résumé
Although many demographic and clinical predictors of mortality have been studied in relation to COVID-19, little has been reported about the prognostic utility of inflammatory biomarkers.
Retrospective cohort study. All patients with laboratory-confirmed COVID-19 treated in a hospital emergency department were included consecutively if baseline measurements of the following biomarkers were on record: lymphocyte counts, neutrophil-to-lymphocyte ratio NRL, and C-reactive protein (CRP) and procalcitonin (PCT) levels. We analyzed associations between the biomarkers and all-cause 30-day mortality using Cox regression models and dose-response curves.
We included 896 patients, 151 (17%) of whom died within 30 days. The median (interquartile range) age was 63 (51-78) years, and 494 (55%) were men. NLR, CRP and PCT levels at ED presentation were higher, while lymphocyte counts were lower, in patients who died compared to those who survived (P .001). The areas under the receiver operating characteristic curves revealed the PCT concentration (0.79; 95% CI, 0.75-0.83) to be a better predictor of 30-day mortality than the lymphocyte count (0.70; 95% CI, 0.65-0.74; P .001), the NLR (0.74; 95% CI, 0.69-0.78; P = .03), or the CRP level (0.72; 95% CI, 0.68-0.76; P .001). The proposed PCT concentration decision points for use in emergency department case management were 0.06 ng/L (negative) and 0.72 ng/L (positive). These cutoffs helped classify risk in 357 patients (40%). Multivariable analysis demonstrated that the PCT concentration had the strongest association with mortality.
PCT concentration in the emergency department predicts all-cause 30-day mortality in patients with COVID-19 better than other inflammatory biomarkers.
Retrospective cohort study. All patients with laboratory-confirmed COVID-19 treated in a hospital emergency department were included consecutively if baseline measurements of the following biomarkers were on record: lymphocyte counts, neutrophil-to-lymphocyte ratio NRL, and C-reactive protein (CRP) and procalcitonin (PCT) levels. We analyzed associations between the biomarkers and all-cause 30-day mortality using Cox regression models and dose-response curves.
We included 896 patients, 151 (17%) of whom died within 30 days. The median (interquartile range) age was 63 (51-78) years, and 494 (55%) were men. NLR, CRP and PCT levels at ED presentation were higher, while lymphocyte counts were lower, in patients who died compared to those who survived (P .001). The areas under the receiver operating characteristic curves revealed the PCT concentration (0.79; 95% CI, 0.75-0.83) to be a better predictor of 30-day mortality than the lymphocyte count (0.70; 95% CI, 0.65-0.74; P .001), the NLR (0.74; 95% CI, 0.69-0.78; P = .03), or the CRP level (0.72; 95% CI, 0.68-0.76; P .001). The proposed PCT concentration decision points for use in emergency department case management were 0.06 ng/L (negative) and 0.72 ng/L (positive). These cutoffs helped classify risk in 357 patients (40%). Multivariable analysis demonstrated that the PCT concentration had the strongest association with mortality.
PCT concentration in the emergency department predicts all-cause 30-day mortality in patients with COVID-19 better than other inflammatory biomarkers.
Sujets
PID Serval
serval:BIB_74504AC9E2AD
PMID
Date de création
2022-03-21T08:12:02.335Z
Date de création dans IRIS
2025-05-20T21:56:42Z