Predictive Values of Procalcitonin and Presepsin for Acute Kidney Injury and 30-Day Hospital Mortality in Patients with COVID-19
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Population
2.2. Data Collection
2.3. Statistical Analysis
3. Results
3.1. AKI Predictive Value of PCT and PSS at ED Admission
3.2. 30-Day Hospital Mortality Predictive Value of PCT and PSS at ED Admission
3.3. Correlation between PCT, PSS, and Other Laboratory Biomarkers
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | Overall (n = 151) | Patients without AKI (n = 95) | Patients with AKI (n = 56) | p-Value |
---|---|---|---|---|
Age, years | 77 (67–84) | 77 (67–84) | 79 (65–85) | 0.881 |
Male | 86 (57.0) | 58 (61.1) | 28 (50.0) | 0.234 |
Comorbidity | ||||
Diabetes mellitus | 42 (27.8) | 27 (28.4) | 15 (26.8) | 0.853 |
Hypertension | 73 (48.3) | 45 (47.4) | 28 (50.0) | 0.866 |
Chronic liver disease | 8 (5.3) | 3 (3.2) | 5 (8.9) | 0.147 |
Chronic lung disease | 10 (6.6) | 4 (4.2) | 5 (10.7) | 0.174 |
Cerebrovascular disease | 49 (32.5) | 30 (31.6) | 19 (33.9) | 0.857 |
Coronary artery disease | 7 (4.6) | 6 (6.3) | 1 (1.8) | 0.260 |
Vital sign | ||||
Systolic blood pressure, mmHg | 115 (97–132) | 116 (100–139) | 110 (88–127) | 0.012 |
Diastolic blood pressure, mmHg | 66 (56–77) | 67 (57–82) | 61 (53–71) | 0.001 |
Heart rate, beats/min | 100 (86–116) | 100 (86–114) | 100 (87–118) | 0.318 |
Respiratory rate, breaths/min | 20 (20–23) | 20 (19–23) | 21 (20–25) | 0.028 |
Body temperature, °C | 37.2 (36.6–38.2) | 37.4 (36.6–38.1) | 37.2 (36.7–38.3) | 0.774 |
CURB-65 score | 2 (1–3) | 2 (1–2) | 2 (1–3) | 0.045 |
Pneumonia severity index | 100 (81–126) | 94 (78–120) | 110 (87–141) | 0.006 |
Death | 19 (12.6) | 7 (7.4) | 12 (21.4) | 0.020 |
Variable | Patients without AKI (n = 95) | Patients with AKI (n = 56) | p-Value |
---|---|---|---|
WBC count, ×103/μL | 10,920 (7365–15,040) | 11,150 (7465–14,945) | 0.331 |
BUN, mg/dL | 18.6 (12.1–33.0) | 31.8 (21.0–51.0) | <0.001 |
Creatinine, mg/dL | 0.72 (0.56–0.84) | 0.73 (0.61–0.92) | 0.392 |
Albumin, g/dL | 3.6 (3.4–3.9) | 3.3 (2.9–3.7) | 0.004 |
hsCRP, mg/dL | 9.50 (4.65–20.55) | 13.01 (6.49–23.6) | 0.117 |
Lactate, mmol/L | 2.12 (1.56–3.38) | 3.30 (2.00–5.74) | 0.003 |
Procalcitonin, ng/mL | 0.29 (0.06–1.35) | 6.62 (0.89–9.99) | <0.001 |
Presepsin, pg/mL | 447 (239–658) | 801 (442–1589) | <0.001 |
Variable | AKI Stage 1 (n = 31) | AKI Stage 2 (n = 11) | AKI Stage 3 (n = 14) | p-Value |
---|---|---|---|---|
WBC count, ×103/μL | 11,150 (7090–15,530) | 9750 (6048–20,593) | 11,400 (8235–14,816) | 0.721 |
BUN, mg/dL | 25.2 (18.6–42.1) | 26.3 (23.0–33.2) c | 56.0 (45.0–71.9) b | 0.002 |
Albumin, g/dL | 3.4 (3.1–3.7) | 3.5 (2.9–3.7) | 3.1 (2.7–3.5) | 0.554 |
hsCRP, mg/dL | 11.23 (3.44–21.52) | 14.2 (6.4–23.6) | 21.8 (11.4–29.9) | 0.151 |
Lactate, mmol/L | 2.45 (1.97–5.37) | 3.70 (2.09–5.90) | 3.67 (2.48–6.26) | 0.588 |
Procalcitonin, ng/mL | 7.62 (0.93–10.75) | 4.28 (0.56–8.28) | 4.64 (0.79–9.96) | 0.581 |
Presepsin, pg/mL | 656 (347–1058) b | 1302 (691–1639) a | 1695 (530–2847) | 0.078 |
Variable | AUC | 95% CI | Cutoff Value | Sensitivity (%) | Specificity (%) | p-Value |
---|---|---|---|---|---|---|
BUN | 0.659 | 0.582–0.724 | >19.8 | 83.9 | 62.1 | <0.001 |
Albumin | 0.641 | 0.559–0.717 | <3.2 | 42.9 | 82.1 | 0.003 |
Lactate | 0.649 | 0.564–0.728 | >1.79 | 87.0 | 37.7 | 0.002 |
Procalcitonin | 0.811 | 0.739–0.870 | >2.26 | 64.3 | 89.5 | <0.001 |
Presepsin | 0.700 | 0.615–0.776 | >572 | 66.0 | 69.1 | <0.001 |
Variable | Survivors (n = 132) | Non-Survivors (n = 19) | p-Value |
---|---|---|---|
Age, years | 77 (67–85) | 77 (66–83) | 0.682 |
Male | 74 (56.1) | 12 (63.2) | 0.627 |
Comorbidity | |||
Diabetes mellitus | 38 (28.8) | 4 (21.1) | 0.592 |
Hypertension | 64 (48.5) | 9 (47.4) | 0.927 |
Chronic liver disease | 5 (3.8) | 3 (15.8) | 0.063 |
Chronic lung disease | 9 (6.8) | 1 (5.3) | 0.799 |
Cerebrovascular disease | 45 (34.1) | 4 (21.1) | 0.305 |
Coronary artery disease | 7 (5.3) | 0 (0) | 0.597 |
Vital sign | |||
Systolic blood pressure, mmHg | 116 (99–133) | 93 (88–119) | 0.243 |
Diastolic blood pressure, mmHg | 66 (56–79) | 53 (51–65) | 0.023 |
Heart rate, beats/min | 100 (89–116) | 87 (83–117) | 0.726 |
Respiratory rate, breaths/min | 20 (20–23) | 20 (19–23) | 0.076 |
Body temperature, °C | 37.4 (36.7–38.4) | 36.5 (36.0–37.0) | 0.002 |
CURB-65 score | 2 (1–3) | 3 (2–4) | <0.001 |
Pneumonia severity index | 97 (80–120) | 138 (125–178) | <0.001 |
Acute kidney injury | 44 (33.3) | 12 (63.2) | 0.020 |
Variable | Survivors (n = 132) | Non-Survivors (n = 19) | p-Value |
---|---|---|---|
WBC count, × 103/μL | 10,700 (7390–14,930) | 12,100 (6705–17,890) | 0.365 |
BUN, mg/dL | 21.8 (15.7–39.7) | 29.8 (24.4–57.8) | 0.016 |
Albumin, g/dL | 3.6 (3.2–3.9) | 2.9 (2.7–3.6) | 0.004 |
hsCRP, mg/dL | 11.65 (4.80–21.81) | 19.07 (5.03–30.88) | 0.194 |
Lactate, mmol/L | 2.32 (1.72–3.99) | 3.33 (2.31–6.82) | 0.034 |
Procalcitonin, ng/mL | 0.70 (0.09–3.51) | 9.98 (4.42–12.32) | < 0.001 |
Presepsin, pg/mL | 495 (258–845) | 1441 (960–1935) | < 0.001 |
Variable | AUC | 95% CI | Cutoff Value | Sensitivity (%) | Specificity (%) | p-Value |
---|---|---|---|---|---|---|
BUN | 0.671 | 0.590–0.746 | >17.7 | 94.7 | 40.2 | 0.004 |
Albumin | 0.702 | 0.622–0.773 | <3.3 | 68.4 | 71.2 | 0.009 |
Lactate | 0.652 | 0.567–0.731 | >2.24 | 84.2 | 48.3 | 0.021 |
Procalcitonin | 0.769 | 0.694–0.834 | >2.67 | 68.4 | 77.3 | <0.001 |
Presepsin | 0.846 | 0.774–0.903 | >865 | 84.6 | 76.0 | <0.001 |
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Kim, S.-Y.; Hong, D.-Y.; Kim, J.-W.; Park, S.-O.; Lee, K.-R.; Baek, K.-J. Predictive Values of Procalcitonin and Presepsin for Acute Kidney Injury and 30-Day Hospital Mortality in Patients with COVID-19. Medicina 2022, 58, 727. https://doi.org/10.3390/medicina58060727
Kim S-Y, Hong D-Y, Kim J-W, Park S-O, Lee K-R, Baek K-J. Predictive Values of Procalcitonin and Presepsin for Acute Kidney Injury and 30-Day Hospital Mortality in Patients with COVID-19. Medicina. 2022; 58(6):727. https://doi.org/10.3390/medicina58060727
Chicago/Turabian StyleKim, Sin-Young, Dae-Young Hong, Jong-Won Kim, Sang-O Park, Kyeong-Ryong Lee, and Kwang-Je Baek. 2022. "Predictive Values of Procalcitonin and Presepsin for Acute Kidney Injury and 30-Day Hospital Mortality in Patients with COVID-19" Medicina 58, no. 6: 727. https://doi.org/10.3390/medicina58060727