Friday, March 19, 2021

Procal in COVID-19

Q: Elevated procalcitonin can be used reliably to add antibiotics in hospitalized COVID-19 patients? 

A) True 
B) False 


In advance COVID-19 patients, despite lack of any other evidence for infections, procalcitonin levels are found to be elevated. It is up to clinician discretion in such cases to add or hold back on antibiotics. The prudent thing would be to draw blood cultures, sputum culture and perform urinanalysis (UA) and decide in conjugation with other clinical evidence. Infectious Disease (ID) consult may be helpful too. 

A low procalcitonin level may be more helpful in deciding against the addition of antibiotics.



1. Guan WJ, Ni ZY, Hu Y, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med 2020; 382:1708. 

2. Wu C, Chen X, Cai Y, et al. Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China. JAMA Intern Med 2020; 180:934. 

3. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020; 395:1054.

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