Diagnostic Utility of a Ferritin-to-Procalcitonin Ratio to Differentiate Patients With COVID-19 From Those With Bacterial Pneumonia: A Multicenter Study.
Diagnostic Utility of a Ferritin-to-Procalcitonin Ratio to Differentiate Patients With COVID-19 From Those With Bacterial Pneumonia: A Multicenter Study.
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DOI：
10.1093/ofid/ofab124
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发表时间：
2021-06
影响因子：
4.2
通讯作者：
Shapiro L
中科院分区：
文献类型：
--
作者：
Gharamti AA;Mei F;Jankousky KC;Huang J;Hyson P;Chastain DB;Fan J;Osae S;Zhang WW;Montoya JG;Erlandson KM;Scherger SJ;Franco-Paredes C;Henao-Martínez AF;Shapiro L
迫切需要准确、快速、廉价的生物标志物来区分 2019 年冠状病毒病 (COVID-19) 和细菌性肺炎。我们评估了铁蛋白与降钙素原 (F/P) 比率的作用，将肺炎病例分为 COVID-19 引起的肺炎病例和细菌病原体引起的肺炎病例。这项多中心病例对照研究对 2020 年 3 月 1 日至 5 月 31 日期间入院的 COVID-19 患者与细菌性肺炎患者进行了比较。排除了 COVID-19 和细菌性肺炎合并感染的患者。比较了 COVID-19 患者与细菌性肺炎患者的 F/P。受试者工作特征曲线分析确定了 COVID-19 与细菌性肺炎的各种截止 F/P 值的敏感性和特异性。总共纳入了 242 例 COVID-19 肺炎病例和 34 例细菌性肺炎对照病例。与细菌性肺炎患者相比，COVID-19 肺炎患者的平均年龄较低（57.1 岁 vs 64.4 岁；P = .02），体重指数较高（30.74 vs 27.15 kg/m2；P = .02）。病例和对照的女性比例相似（47% vs 53%；P = .5），而COVID-19患者的糖尿病患病率较高（32.6% vs 12%；P = .01）。与细菌性肺炎患者的 F/P (802；P < .001) 相比，COVID-19 患者的 F/P 中位数 (4037.5) 显着更高。用于诊断 COVID-19 的 F/P ≥ 877 的敏感性为 85%，特异性为 56%，阳性预测值为 93.2%，似然比为 1.92。在多变量分析中，F/P ≥877 与识别出 COVID-19 病例的几率较高相关（优势比，11.27；95% CI，4–31.2；P < .001）。与细菌性肺炎相比，F/P ≥ 877 会增加患 COVID-19 肺炎的可能性。
There is an urgent need for accurate, rapid, inexpensive biomarkers that can differentiate coronavirus disease 2019 (COVID-19) from bacterial pneumonia. We assess the role of the ferritin-to-procalcitonin (F/P) ratio to classify pneumonia cases into those due to COVID-19 vs those due to bacterial pathogens. This multicenter case–control study compared patients with COVID-19 with those with bacterial pneumonia, admitted between March 1 and May 31, 2020. Patients with COVID-19 and bacterial pneumonia co-infection were excluded. The F/P in patients with COVID-19 vs with bacterial pneumonia were compared. Receiver operating characteristic curve analysis determined the sensitivity and specificity of various cutoff F/P values for COVID-19 vs bacterial pneumonia. A total of 242 COVID-19 pneumonia cases and 34 bacterial pneumonia controls were included. Patients with COVID-19 pneumonia had a lower mean age (57.1 vs 64.4 years; P = .02) and a higher body mass index (30.74 vs 27.15 kg/m2; P = .02) compared with patients with bacterial pneumonia. Cases and controls had a similar proportion of women (47% vs 53%; P = .5), and COVID-19 patients had a higher prevalence of diabetes mellitus (32.6% vs 12%; P = .01). The median F/P was significantly higher in patients with COVID-19 (4037.5) compared with the F/P in bacterial pneumonia (802; P < .001). An F/P ≥877, used to diagnose COVID-19, resulted in a sensitivity of 85% and a specificity of 56%, with a positive predictive value of 93.2% and a likelihood ratio of 1.92. In multivariable analyses, an F/P ≥877 was associated with greater odds of identifying a COVID-19 case (odds ratio, 11.27; 95% CI, 4–31.2; P < .001). An F/P ≥877 increases the likelihood of COVID-19 pneumonia compared with bacterial pneumonia.
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