Han Jin , MD 1 , a , Shengwen Yang , MD 2 , a , Pengkang He , MD 1 , a , Haoyu Weng , MD 1 , Shengcong Liu , MD 1 , Fan Yang , MD 1 , Long Zhang , MD 1 , Fangfang Fan , PhD 1 , Yan Zhang , MD, PhD 1 , Jing Zhou , MD, PhD , 1 , Jianping Li , MD, PhD , 1
Background: We evaluated whether the serum procalcitonin (PCT) level could predict death in severe and critical coronavirus disease 2019 (COVID-19) patients.
Methods: This study included 129 COVID-19 patients. PCT levels on admission, treatment, and death were collected. The outcomes were compared.
Results: The optimum cutoff value of the PCT level determined by receiver operator characteristic curve analysis to predict all-cause death was 0.085 ng/mL, with sensitivity of 95.7% and specificity of 72.6%. Overall, 78 patients had a PCT level below 0.085 ng/mL and 51 patients had a PCT level of 0.085 ng/mL or greater. High-PCT-level patients had lower levels of lymphocytes (P=0.001) and albumin (P=0.002) and higher levels of creatinine (P=0.024), D-dimer (P=0.002), and white blood cells, neutrocytes (P<0.001), high-sensitivity C-reactive protein (P<0.001), interleukin-6 (P<0.001), interleukin-8 (P=0.001), interleukin-10 (P=0.001), tumor necrosis factor (P<0.001), erythrocyte sedimentation rate (P=0.001), and ferritin (P=0.001). During the 30-day observation period, 23 patients died. Mortality was significantly higher in high-PCT-level patients than in patients with low PCT levels (43.1% vs. 1.3%; P<0.001). The risks of death (P<0.0001) and ventilator use (P<0.0001) were increased in patients with PCT levels of 0.085 ng/mL or greater.
Conclusions: A PCT level of 0.085 ng/mL or greater on admission could effectively predict death and ventilator use in severe and critical COVID-19 patients.