Faculty Collaboration Database

Association between procalcitonin levels and duration of mechanical ventilation in COVID-19 patients. PLoS One 2020;15(9):e0239174

Date

09/19/2020

Pubmed ID

32946466

Pubmed Central ID

PMC7500634

DOI

10.1371/journal.pone.0239174

Scopus ID

2-s2.0-85091324134 (requires institutional sign-in at Scopus site)   20 Citations

Abstract

BACKGROUND: Patients diagnosed with COVID-19 frequently require mechanical ventilation. Knowledge of laboratory tests associated with the prolonged need for mechanical ventilation may guide resource allocation. We hypothesized that an elevated plasma procalcitonin level (>0.1 ng/ml) would be associated with the duration of invasive mechanical ventilation.

METHODS: Patients diagnosed with COVID-19, who were admitted to any of our health system's hospitals between March 9th-April 20th, 2020 and required invasive mechanical ventilation, were eligible for this observational cohort study. Demographics, comorbidities, components of the Sequential Organ Failure Assessment score, and procalcitonin levels on admission were obtained from the electronic health record. The primary outcome was the duration of mechanical ventilation; secondary outcomes included 28-day mortality and time to intubation. Outcomes were assessed within the first 28 days of admission. Baseline demographics and comorbidities were summarized by descriptive statistics. Univariate comparisons were made using Pearson's chi-square test for binary outcomes and Mann-Whitney U test for continuous outcomes. A multiple linear regression was fitted to assess the association between procalcitonin levels and the duration of mechanical ventilation.

RESULTS: Patients with an initial procalcitonin level >0.1 ng/ml required a significantly longer duration of mechanical ventilation than patients with a level of ≤0.1 ng/ml (p = 0.021) in the univariate analysis. There was no significant difference in 28-day mortality or time to intubation between the two groups. After adjusted analysis using multivariable linear regression, the duration of mechanical ventilation was, on average, 5.6 (p = 0.016) days longer in patients with an initial procalcitonin level >0.1 ng/ml.

CONCLUSION: In this cohort of 93 mechanically ventilated COVID-19 patients, we found an association between an initial plasma procalcitonin level >0.1 ng/ml and the duration of mechanical ventilation. These findings may help to identify patients at risk for prolonged mechanical ventilation upon admission.

Author List

Krause M, Douin DJ, Tran TT, Fernandez-Bustamante A, Aftab M, Bartels K

Author

Timothy Tran MD Associate Professor in the Anesthesiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Betacoronavirus
Cohort Studies
Comorbidity
Coronavirus Infections
Female
Hospital Mortality
Humans
Linear Models
Male
Middle Aged
Pandemics
Pneumonia, Viral
Resource Allocation
Respiration, Artificial
Time Factors
Time-to-Treatment