Role of Procalcitonin as a Prognostic Biomarker in Hospitalized COVID-19 Patients: A Comparative Analysis
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: T...
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SAGE Publishing
2025-05-01
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| Series: | Biomarker Insights |
| Online Access: | https://doi.org/10.1177/11772719241296624 |
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| author | Shahin Isha Lekhya Raavi Sadhana Jonna Hrishikesh Nataraja Emily C Craver Anna Jenkins Abby J Hanson Prasanth Balasubramanian Arvind Balavenkataraman Aysun Tekin Vikas Bansal Swetha Reddy Sean M Caples Syed Anjum Khan Nitesh K Jain Abigail T LaNou Rahul Kashyap Rodrigo Cartin-Ceba Ricardo Diaz Milian Carla P Venegas Anna B Shapiro Anirban Bhattacharyya Sanjay Chaudhary Sean P Kiley Quintin J Quinones Neal M Patel Pramod K Guru Pablo Moreno Franco Archana Roy Devang K Sanghavi |
| author_facet | Shahin Isha Lekhya Raavi Sadhana Jonna Hrishikesh Nataraja Emily C Craver Anna Jenkins Abby J Hanson Prasanth Balasubramanian Arvind Balavenkataraman Aysun Tekin Vikas Bansal Swetha Reddy Sean M Caples Syed Anjum Khan Nitesh K Jain Abigail T LaNou Rahul Kashyap Rodrigo Cartin-Ceba Ricardo Diaz Milian Carla P Venegas Anna B Shapiro Anirban Bhattacharyya Sanjay Chaudhary Sean P Kiley Quintin J Quinones Neal M Patel Pramod K Guru Pablo Moreno Franco Archana Roy Devang K Sanghavi |
| author_sort | Shahin Isha |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-1efa2b12e5cf426a89d10705450466be |
| institution | OA Journals |
| issn | 1177-2719 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Biomarker Insights |
| spelling | doaj-art-1efa2b12e5cf426a89d10705450466be2025-08-20T02:31:41ZengSAGE PublishingBiomarker Insights1177-27192025-05-012010.1177/11772719241296624Role of Procalcitonin as a Prognostic Biomarker in Hospitalized COVID-19 Patients: A Comparative AnalysisShahin Isha0Lekhya Raavi1Sadhana Jonna2Hrishikesh Nataraja3Emily C Craver4Anna Jenkins5Abby J Hanson6Prasanth Balasubramanian7Arvind Balavenkataraman8Aysun Tekin9Vikas Bansal10Swetha Reddy11Sean M Caples12Syed Anjum Khan13Nitesh K Jain14Abigail T LaNou15Rahul Kashyap16Rodrigo Cartin-Ceba17Ricardo Diaz Milian18Carla P Venegas19Anna B Shapiro20Anirban Bhattacharyya21Sanjay Chaudhary22Sean P Kiley23Quintin J Quinones24Neal M Patel25Pramod K Guru26Pablo Moreno Franco27Archana Roy28Devang K Sanghavi29Department of Critical Care Medicine, Mayo Clinic in Florida, Jacksonville, FL, USADepartment of Critical Care Medicine, Mayo Clinic in Florida, Jacksonville, FL, USADepartment of Critical Care Medicine, Mayo Clinic in Florida, Jacksonville, FL, USADepartment of Critical Care Medicine, Mayo Clinic in Florida, Jacksonville, FL, USADepartment of Quantitative Health Sciences, Mayo Clinic in Florida, Jacksonville, FL, USADepartment of Critical Care Medicine, Mayo Clinic in Florida, Jacksonville, FL, USADepartment of Critical Care Medicine, Mayo Clinic in Florida, Jacksonville, FL, USADepartment of Pulmonary and Critical Care, Mayo Clinic in Florida, Jacksonville, FL, USADepartment of Pulmonary and Critical Care, Mayo Clinic in Florida, Jacksonville, FL, USADepartment of Critical Care Medicine, Mayo Clinic Rochester, MN, USADepartment of Critical Care Medicine, Mayo Clinic Rochester, MN, USADepartment of Critical Care Medicine, Mayo Clinic in Florida, Jacksonville, FL, USADivision of Pulmonary and Critical Care, Mayo Clinic Rochester, MN, USADepartment of Critical Care Medicine, Mayo Clinic Health System in Mankato, Mankato, MN, USADepartment of Critical Care Medicine, Mayo Clinic Health System in Mankato, Mankato, MN, USAEmergency Medicine and Critical Care, Mayo Clinic Health System, Eau Claire, WI, USADepartment of Anesthesia and Critical Care Medicine, Mayo Clinic Rochester, MN, USADepartment of Critical Care Medicine, Mayo Clinic Arizona, Phoenix, AZ, USADepartment of Critical Care Medicine, Mayo Clinic in Florida, Jacksonville, FL, USADepartment of Critical Care Medicine, Mayo Clinic in Florida, Jacksonville, FL, USADepartment of Critical Care Medicine, Mayo Clinic in Florida, Jacksonville, FL, USADepartment of Critical Care Medicine, Mayo Clinic in Florida, Jacksonville, FL, USADepartment of Critical Care Medicine, Mayo Clinic in Florida, Jacksonville, FL, USADepartment of Critical Care Medicine, Mayo Clinic in Florida, Jacksonville, FL, USADepartment of Critical Care Medicine, Mayo Clinic in Florida, Jacksonville, FL, USADepartment of Critical Care Medicine, Mayo Clinic in Florida, Jacksonville, FL, USADepartment of Critical Care Medicine, Mayo Clinic in Florida, Jacksonville, FL, USADepartment of Critical Care Medicine, Mayo Clinic in Florida, Jacksonville, FL, USADivision of Hospital Internal Medicine, Mayo Clinic, Jacksonville, FL, USADepartment of Critical Care Medicine, Mayo Clinic in Florida, Jacksonville, FL, USABackground: 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.https://doi.org/10.1177/11772719241296624 |
| spellingShingle | Shahin Isha Lekhya Raavi Sadhana Jonna Hrishikesh Nataraja Emily C Craver Anna Jenkins Abby J Hanson Prasanth Balasubramanian Arvind Balavenkataraman Aysun Tekin Vikas Bansal Swetha Reddy Sean M Caples Syed Anjum Khan Nitesh K Jain Abigail T LaNou Rahul Kashyap Rodrigo Cartin-Ceba Ricardo Diaz Milian Carla P Venegas Anna B Shapiro Anirban Bhattacharyya Sanjay Chaudhary Sean P Kiley Quintin J Quinones Neal M Patel Pramod K Guru Pablo Moreno Franco Archana Roy Devang K Sanghavi Role of Procalcitonin as a Prognostic Biomarker in Hospitalized COVID-19 Patients: A Comparative Analysis Biomarker Insights |
| title | Role of Procalcitonin as a Prognostic Biomarker in Hospitalized COVID-19 Patients: A Comparative Analysis |
| title_full | Role of Procalcitonin as a Prognostic Biomarker in Hospitalized COVID-19 Patients: A Comparative Analysis |
| title_fullStr | Role of Procalcitonin as a Prognostic Biomarker in Hospitalized COVID-19 Patients: A Comparative Analysis |
| title_full_unstemmed | Role of Procalcitonin as a Prognostic Biomarker in Hospitalized COVID-19 Patients: A Comparative Analysis |
| title_short | Role of Procalcitonin as a Prognostic Biomarker in Hospitalized COVID-19 Patients: A Comparative Analysis |
| title_sort | role of procalcitonin as a prognostic biomarker in hospitalized covid 19 patients a comparative analysis |
| url | https://doi.org/10.1177/11772719241296624 |
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