Association of Serum Procalcitonin Level with Severity of COVID-19 among Patients in Ajman, United Arab Emirates

ORIGINAL ARTICLE
Reem Ali, Salma Elnour1, Hasan Higazi, Ahmed L. Osman, Marwan Ismail, Abdelgadir Alamin Altoum, Ayman Hussien Alfeel, Praveen Kumar Kandakurti, Noha Kamal Abdel Moamen, Salah Eldin Omar Hussein, Sara Ali

 
International Journal of Biomedicine. 2023;13(2):245-249.
DOI: 10.21103/Article13(2)_OA7
Originally published June 5, 2023

Abstract: 

The aim of the current study was to assess the association between the mean level of procalcitonin (PCT), demographic characteristics, and the symptoms, duration, and severity of COVID-19.
Methods and Results: This cross-sectional study included patients with a confirmed COVID-19 infection who visited the Thumbay Hospital in Ajman (UAE) between March and June 2022. A total of 231 COVID-19-positive patient records (170[73.6%] males and 61[26.4%] females) were included in the study. PCT levels were measured upon admission using the Beckman Coulter – UniCel DxI 800 Access Immunoassay System.
The mean patients’ age was 47.44±13.460 years, and the length of stay in the hospital was 11.21±8.145 days. The PCT mean level was 0.545±1.739 ng/ml with minimum and maximum values of 0.010 ng/ml and 16.667 ng/ml, respectively. In terms of COVID-19 severity, patients were categorized into mild (121[52.4%]), moderate (59[25.5%]), and severe 51(22.1%]). We found no association between age categories and COVID-19 severity. There was a statistically significant difference in the mean PCT level among the severity groups. The mean PCT level increased with increasing severity of COVID-19: 0.0569±0.0324, 0.1736±0.0594, and 2.134±3.254 ng/ml for mild, moderate, and severe COVID-19, respectively (P=0.0000) There was a statistically significant, moderate positive correlation between PCT level and disease severity (r=0.433, P=0.001). The linear regression results revealed that PCT level is a significant factor in COVID-19 severity.
Conclusion: The current study demonstrates that the serum PCT level may be a marker of disease severity in patients infected with SARS-CoV-2.

Keywords: 
SARS-CoV-2 • COVID-19 • procalcitonin • disease severity
References: 
  1. UAE CORONAVIRUS (COVID-19) UPDATES. Available from: https://covid19.ncema.gov.ae/en
  2. Wong LE, Hawkins JE, Langness S, Murrell KL, Iris P, Sammann A. Where are all the patients? Addressing Covid-19 fear to encourage sick patients to seek emergency care. Nejm Catalyst. 2020 May 14;1(3):1-2.
  3. Booth A, Reed AB, Ponzo S, Yassaee A, Aral M, Plans D, Labrique A, Mohan D. Population risk factors for severe disease and mortality in COVID-19: A global systematic review and meta-analysis. PLoS One. 2021 Mar 4;16(3):e0247461. doi: 10.1371/journal.pone.0247461. 
  4. World Health Organization. Coronavirus disease (COVID-19) Pandemic. Retrieved from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019
  5. Centers for Disease Control and Prevention. Symptoms of COVID-19. Available from: https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html.
  6. Tjendra Y, Al Mana AF, Espejo AP, Akgun Y, Millan NC, Gomez-Fernandez C, Cray C. Predicting Disease Severity and Outcome in COVID-19 Patients: A Review of Multiple Biomarkers. Arch Pathol Lab Med. 2020 Dec 1;144(12):1465-1474. doi: 10.5858/arpa.2020-0471-SA. 
  7. Jackson I, Jaradeh H, Aurit S, Aldamen A, Narechania S, Destache C, Velagapudi M. Role of procalcitonin as a predictor of clinical outcomes in hospitalized patients with COVID-19. Int J Infect Dis. 2022 Jun;119:47-52. doi: 10.1016/j.ijid.2022.03.044.
  8. Merad M, Martin JC. Pathological inflammation in patients with COVID-19: a key role for monocytes and macrophages. Nat Rev Immunol. 2020 Jun;20(6):355-362. doi: 10.1038/s41577-020-0331-4. Epub 2020 May 6. Erratum in: Nat Rev Immunol. 2020 Jun 2;: PMID: 32376901; PMCID: PMC7201395.
  9. Huang I, Pranata R, Lim MA, Oehadian A, Alisjahbana B. C-reactive protein, procalcitonin, D-dimer, and ferritin in severe coronavirus disease-2019: a meta-analysis. Ther Adv Respir Dis. 2020 Jan-Dec;14:1753466620937175. doi: 10.1177/1753466620937175.
  10. Hu R, Han C, Pei S, Yin M, Chen X. Procalcitonin levels in COVID-19 patients. Int J Antimicrob Agents. 2020 Aug;56(2):106051. doi: 10.1016/j.ijantimicag.2020.106051.
  11. Lippi G, Plebani M. Procalcitonin in patients with severe coronavirus disease 2019 (COVID-19): A meta-analysis. Clin Chim Acta. 2020 Jun;505:190-191. doi: 10.1016/j.cca.2020.03.004.
  12. Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al.; China Medical Treatment Expert Group for Covid-19. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020 Apr 30;382(18):1708-1720. doi: 10.1056/NEJMoa2002032. 
  13. Zhang JJ, Dong X, Cao YY, Yuan YD, Yang YB, Yan YQ, et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy. 2020 Jul;75(7):1730-1741. doi: 10.1111/all.14238.
  14. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020 Feb 15;395(10223):497-506. doi: 10.1016/S0140-6736(20)30183-5. Epub 2020 Jan 24. Erratum in: Lancet. 2020 Jan 30: PMID: 31986264.
  15. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020 Mar 17;323(11):1061-1069. doi: 10.1001/jama.2020.1585. Erratum in: JAMA. 2021 Mar 16;325(11):1113. 
  16. Kotula JJ 3rd, Moore WS 2nd, Chopra A, Cies JJ. Association of Procalcitonin Value and Bacterial Coinfections in Pediatric Patients With Viral Lower Respiratory Tract Infections Admitted to the Pediatric Intensive Care Unit. J Pediatr Pharmacol Ther. 2018 Nov-Dec;23(6):466-472. doi: 10.5863/1551-6776-23.6.466. 

Download Article
Received February 7, 2023.
Accepted March 28, 2023.
©2023 International Medical Research and Development Corporation.