Serum Procalcitonin Levels on Admission Predict Death in Severe and Critical COVID-19 Patients in Wuhan, China

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 specifi city 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.