Procalcitonin Is Not a Reliable Biomarker of Bacterial Coinfection in People With Coronavirus Disease 2019 Undergoing Microbiological Investigation at the Time of Hospital Admission

International Severe Acute Respiratory and Emerging Infections Consortium Coronavirus Clinical Characterisation Consortium (ISARIC4C) Investigators; Katharine A Relph; Clark D Russell; Cameron J Fairfield; Lance Turtle; Thushan I de Silva; Matthew K Siggins; Thomas M Drake; Ryan S Thwaites; Simon Abrams; Shona C Moore; Hayley E Hardwick; Wilna Oosthuyzen; Ewen M Harrison; Annemarie B Docherty; Peter J M Openshaw; J Kenneth  Baillie; Malcolm G Semple; Antonia Ho

doi:10.1093/ofid/ofac179

Procalcitonin Is Not a Reliable Biomarker of Bacterial Coinfection in People With Coronavirus Disease 2019 Undergoing Microbiological Investigation at the Time of Hospital Admission

International Severe Acute Respiratory and Emerging Infections Consortium Coronavirus Clinical Characterisation Consortium (ISARIC4C) Investigators, Katharine A Relph, Clark D Russell^*, Cameron J Fairfield, Lance Turtle, Thushan I de Silva, Matthew K Siggins, Thomas M Drake, Ryan S Thwaites, Simon Abrams, Shona C Moore, Hayley E Hardwick, Wilna Oosthuyzen, Ewen M Harrison, Annemarie B Docherty, Peter J M Openshaw, J Kenneth Baillie, Malcolm G Semple, Antonia Ho

^*Corresponding author for this work

Chemical Engineering

Research output: Contribution to journal › Article › peer-review

Abstract

Admission procalcitonin measurements and microbiology results were available for 1040 hospitalized adults with coronavirus disease 2019 (from 48 902 included in the International Severe Acute Respiratory and Emerging Infections Consortium World Health Organization Clinical Characterisation Protocol UK study). Although procalcitonin was higher in bacterial coinfection, this was neither clinically significant (median [IQR], 0.33 [0.11–1.70] ng/mL vs 0.24 [0.10–0.90] ng/mL) nor diagnostically useful (area under the receiver operating characteristic curve, 0.56 [95% confidence interval, .51–.60]).

Original language	English
Article number	ofac179
Number of pages	6
Journal	Open Forum Infectious Diseases
Volume	9
Issue number	5
DOIs	https://doi.org/10.1093/ofid/ofac179
Publication status	Published - 1 May 2022

Bibliographical note

Financial support:
This work was supported by the National Institute for Health Research (NIHR) (grant number CO-CIN-01); the Medical Research Council (grant number MC_PC_19059); and the NIHR Health Protection Research Unit (HPRU) in Emerging and Zoonotic Infections at University of Liverpool in partnership with Public Health England (PHE), in collaboration with Liverpool School of Tropical Medicine and the University of Oxford (grant number 200907); NIHR HPRU in Respiratory Infections at Imperial College London with PHE (grant number 200927); Wellcome Trust and Department for International Development (grant number 215091/Z/18/Z); the Bill and Melinda Gates Foundation (grant number OPP1209135); Liverpool Experimental Cancer Medicine Centre (grant number C18616/A25153); NIHR Biomedical Research Centre at Imperial College London (grant number IS-BRC-1215-20013); EU Platform for European Preparedness Against (Re-) emerging Epidemics (FP7 project 602525); and NIHR Clinical Research Network for providing infrastructure support for this research. L. T. is supported by a Wellcome Trust fellowship (grant number 205228/Z/16/Z). P. J. M. O. is supported by an NIHR Senior Investigator Award (grant number 201385).

Keywords

COVID-19
SARS-CoV-2
procalcitonin
coinfection

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International Severe Acute Respiratory and Emerging Infections Consortium Coronavirus Clinical Characterisation Consortium (ISARIC4C) Investigators, Relph, K. A., Russell, C. D., Fairfield, C. J., Turtle, L., Silva, T. I. D., Siggins, M. K., Drake, T. M., Thwaites, R. S., Abrams, S., Moore, S. C., Hardwick, H. E., Oosthuyzen, W., Harrison, E. M., Docherty, A. B., Openshaw, P. J. M., Baillie, J. K., Semple, M. G., & Ho, A. (2022). Procalcitonin Is Not a Reliable Biomarker of Bacterial Coinfection in People With Coronavirus Disease 2019 Undergoing Microbiological Investigation at the Time of Hospital Admission. Open Forum Infectious Diseases, 9(5), Article ofac179. https://doi.org/10.1093/ofid/ofac179

International Severe Acute Respiratory and Emerging Infections Consortium Coronavirus Clinical Characterisation Consortium (ISARIC4C) Investigators ; Relph, Katharine A ; Russell, Clark D et al. / Procalcitonin Is Not a Reliable Biomarker of Bacterial Coinfection in People With Coronavirus Disease 2019 Undergoing Microbiological Investigation at the Time of Hospital Admission. In: Open Forum Infectious Diseases. 2022 ; Vol. 9, No. 5.

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title = "Procalcitonin Is Not a Reliable Biomarker of Bacterial Coinfection in People With Coronavirus Disease 2019 Undergoing Microbiological Investigation at the Time of Hospital Admission",

abstract = "Admission procalcitonin measurements and microbiology results were available for 1040 hospitalized adults with coronavirus disease 2019 (from 48 902 included in the International Severe Acute Respiratory and Emerging Infections Consortium World Health Organization Clinical Characterisation Protocol UK study). Although procalcitonin was higher in bacterial coinfection, this was neither clinically significant (median [IQR], 0.33 [0.11–1.70] ng/mL vs 0.24 [0.10–0.90] ng/mL) nor diagnostically useful (area under the receiver operating characteristic curve, 0.56 [95% confidence interval, .51–.60]).",

keywords = "COVID-19, SARS-CoV-2, procalcitonin, coinfection",

author = "{International Severe Acute Respiratory and Emerging Infections Consortium Coronavirus Clinical Characterisation Consortium (ISARIC4C) Investigators} and Relph, {Katharine A} and Russell, {Clark D} and Fairfield, {Cameron J} and Lance Turtle and Silva, {Thushan I de} and Siggins, {Matthew K} and Drake, {Thomas M} and Thwaites, {Ryan S} and Simon Abrams and Moore, {Shona C} and Hardwick, {Hayley E} and Wilna Oosthuyzen and Harrison, {Ewen M} and Docherty, {Annemarie B} and Openshaw, {Peter J M} and Baillie, {J Kenneth} and Semple, {Malcolm G} and Antonia Ho and Christopher Green",

note = "Financial support: This work was supported by the National Institute for Health Research (NIHR) (grant number CO-CIN-01); the Medical Research Council (grant number MC_PC_19059); and the NIHR Health Protection Research Unit (HPRU) in Emerging and Zoonotic Infections at University of Liverpool in partnership with Public Health England (PHE), in collaboration with Liverpool School of Tropical Medicine and the University of Oxford (grant number 200907); NIHR HPRU in Respiratory Infections at Imperial College London with PHE (grant number 200927); Wellcome Trust and Department for International Development (grant number 215091/Z/18/Z); the Bill and Melinda Gates Foundation (grant number OPP1209135); Liverpool Experimental Cancer Medicine Centre (grant number C18616/A25153); NIHR Biomedical Research Centre at Imperial College London (grant number IS-BRC-1215-20013); EU Platform for European Preparedness Against (Re-) emerging Epidemics (FP7 project 602525); and NIHR Clinical Research Network for providing infrastructure support for this research. L. T. is supported by a Wellcome Trust fellowship (grant number 205228/Z/16/Z). P. J. M. O. is supported by an NIHR Senior Investigator Award (grant number 201385).",

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language = "English",

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International Severe Acute Respiratory and Emerging Infections Consortium Coronavirus Clinical Characterisation Consortium (ISARIC4C) Investigators, Relph, KA, Russell, CD, Fairfield, CJ, Turtle, L, Silva, TID, Siggins, MK, Drake, TM, Thwaites, RS, Abrams, S, Moore, SC, Hardwick, HE, Oosthuyzen, W, Harrison, EM, Docherty, AB, Openshaw, PJM, Baillie, JK, Semple, MG & Ho, A 2022, 'Procalcitonin Is Not a Reliable Biomarker of Bacterial Coinfection in People With Coronavirus Disease 2019 Undergoing Microbiological Investigation at the Time of Hospital Admission', Open Forum Infectious Diseases, vol. 9, no. 5, ofac179. https://doi.org/10.1093/ofid/ofac179

Procalcitonin Is Not a Reliable Biomarker of Bacterial Coinfection in People With Coronavirus Disease 2019 Undergoing Microbiological Investigation at the Time of Hospital Admission. / International Severe Acute Respiratory and Emerging Infections Consortium Coronavirus Clinical Characterisation Consortium (ISARIC4C) Investigators; Relph, Katharine A; Russell, Clark D et al.
In: Open Forum Infectious Diseases, Vol. 9, No. 5, ofac179, 01.05.2022.

Research output: Contribution to journal › Article › peer-review

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AU - International Severe Acute Respiratory and Emerging Infections Consortium Coronavirus Clinical Characterisation Consortium (ISARIC4C) Investigators

AU - Relph, Katharine A

AU - Russell, Clark D

AU - Fairfield, Cameron J

AU - Turtle, Lance

AU - Silva, Thushan I de

AU - Siggins, Matthew K

AU - Drake, Thomas M

AU - Thwaites, Ryan S

AU - Abrams, Simon

AU - Moore, Shona C

AU - Hardwick, Hayley E

AU - Oosthuyzen, Wilna

AU - Harrison, Ewen M

AU - Docherty, Annemarie B

AU - Openshaw, Peter J M

AU - Baillie, J Kenneth

AU - Semple, Malcolm G

AU - Ho, Antonia

AU - Green, Christopher

N1 - Financial support: This work was supported by the National Institute for Health Research (NIHR) (grant number CO-CIN-01); the Medical Research Council (grant number MC_PC_19059); and the NIHR Health Protection Research Unit (HPRU) in Emerging and Zoonotic Infections at University of Liverpool in partnership with Public Health England (PHE), in collaboration with Liverpool School of Tropical Medicine and the University of Oxford (grant number 200907); NIHR HPRU in Respiratory Infections at Imperial College London with PHE (grant number 200927); Wellcome Trust and Department for International Development (grant number 215091/Z/18/Z); the Bill and Melinda Gates Foundation (grant number OPP1209135); Liverpool Experimental Cancer Medicine Centre (grant number C18616/A25153); NIHR Biomedical Research Centre at Imperial College London (grant number IS-BRC-1215-20013); EU Platform for European Preparedness Against (Re-) emerging Epidemics (FP7 project 602525); and NIHR Clinical Research Network for providing infrastructure support for this research. L. T. is supported by a Wellcome Trust fellowship (grant number 205228/Z/16/Z). P. J. M. O. is supported by an NIHR Senior Investigator Award (grant number 201385).

PY - 2022/5/1

Y1 - 2022/5/1

N2 - Admission procalcitonin measurements and microbiology results were available for 1040 hospitalized adults with coronavirus disease 2019 (from 48 902 included in the International Severe Acute Respiratory and Emerging Infections Consortium World Health Organization Clinical Characterisation Protocol UK study). Although procalcitonin was higher in bacterial coinfection, this was neither clinically significant (median [IQR], 0.33 [0.11–1.70] ng/mL vs 0.24 [0.10–0.90] ng/mL) nor diagnostically useful (area under the receiver operating characteristic curve, 0.56 [95% confidence interval, .51–.60]).

AB - Admission procalcitonin measurements and microbiology results were available for 1040 hospitalized adults with coronavirus disease 2019 (from 48 902 included in the International Severe Acute Respiratory and Emerging Infections Consortium World Health Organization Clinical Characterisation Protocol UK study). Although procalcitonin was higher in bacterial coinfection, this was neither clinically significant (median [IQR], 0.33 [0.11–1.70] ng/mL vs 0.24 [0.10–0.90] ng/mL) nor diagnostically useful (area under the receiver operating characteristic curve, 0.56 [95% confidence interval, .51–.60]).

KW - COVID-19

KW - SARS-CoV-2

KW - procalcitonin

KW - coinfection

U2 - 10.1093/ofid/ofac179

DO - 10.1093/ofid/ofac179

M3 - Article

SN - 2328-8957

VL - 9

JO - Open Forum Infectious Diseases

JF - Open Forum Infectious Diseases

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M1 - ofac179

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International Severe Acute Respiratory and Emerging Infections Consortium Coronavirus Clinical Characterisation Consortium (ISARIC4C) Investigators, Relph KA, Russell CD, Fairfield CJ, Turtle L, Silva TID et al. Procalcitonin Is Not a Reliable Biomarker of Bacterial Coinfection in People With Coronavirus Disease 2019 Undergoing Microbiological Investigation at the Time of Hospital Admission. Open Forum Infectious Diseases. 2022 May 1;9(5):ofac179. doi: 10.1093/ofid/ofac179

Procalcitonin Is Not a Reliable Biomarker of Bacterial Coinfection in People With Coronavirus Disease 2019 Undergoing Microbiological Investigation at the Time of Hospital Admission

Abstract

Bibliographical note

Keywords

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