Evaluation of Procalcitonin Elevation During Icu Stay and its Relationship with Mortality in Icu Patients for Covid-19 with Respiratory Involvement. A Multicenter Prospective Cohort Study

Introduction: A multicenter prospective cohort study studied patients admitted to the Intensive Care Unit (ICU) by COVID 19 with respiratory involvement. We observed the number of occasions in which the value of procalcitonin (PCT) was higher than 0.5 ng/ml. Objective: Evaluation of PCT elevation and influence on mortality in patients admitted to the ICU for COVID-19 with respiratory involvement. Measurements and Main Results: We studied 201 patients. On the day of admission, Acute Physiology And Chronic Health Evaluation (APACHE)-II was 13 (10-16) points and Sequential Organ Failure Assessment score (SOFA) was (3-7) points. In hospital mortality was 36.8%. During ICU stay, 104 patients presented 1 or more episodes of PCT elevation and 60 (57.3%) died and 97 patients did not present any episodes of PCT elevation and only 14(14.4%) died(p<0.001). Multivariable analysis showed that mortality was associated with APACHE-II (OR:1.14(1.05-1.24)) and with the presentation of one or more episodes of increasing PCT (OR:6.09(2.99-12.41)).74 patients died, of which 56.8% (n=42) of them had an elevated PCT value on the last day, and of the 126 patients who survived, only 6 patients (4.8%) had an elevated PCT value on the last day (p<0.001).On the last day of ICU stay, SOFA of those who died was 9(7-11) and 1(0-2) point in survivors (p<0.001).Of the 42 patients who died and in whom PCT was elevated on the last day, 71.4% were considered to have a mainly non-respiratory cause of death.Conclusions: In patients admitted to the ICU by COVID-19 with respiratory involvement, numerous episodes of PCT elevation are observed, related to mortality. PCT was elevated on the last day in more than half of patients who died. All this suggests that these patients present multiple infectious episodes of bacterial origin, many of them resolved with treatment and others unresolved and patients die.Funding Information: No funding to report.Declaration of Interests: None to report.Ethics Approval Statement: The study protocol was approved by the Research ethics committee of Hospital de Jaen (1508-N-20).