TY - JOUR
T1 - Impact of pneumococcal urinary antigen testing in covid-19 patients
T2 - Outcomes from the san matteo covid-19 registry (smacore)
AU - Valsecchi, Pietro
AU - Colaneri, Marta
AU - Zuccaro, Valentina
AU - Asperges, Erika
AU - Costanzo, Filippo
AU - Mariani, Bianca
AU - Roda, Silvia
AU - Minucci, Rita
AU - Bertuccio, Francesco
AU - Fraoilini, Elia
AU - Bosio, Matteo
AU - Tirelli, Claudio
AU - Oggionni, Tiberio
AU - Corsico, Angelo
AU - Bruno, Raffaele
N1 - Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2021/8
Y1 - 2021/8
N2 - Despite low rates of bacterial co-infections, most COVID-19 patients receive antibiotic therapy. We hypothesized that patients with positive pneumococcal urinary antigens (PUAs) would benefit from antibiotic therapy in terms of clinical outcomes (death, ICU admission, and length of stay). The San Matteo COVID-19 Registry (SMACORE) prospectively enrolls patients admitted for COVID-19 pneumonia at IRCCS Policlinico San Matteo, Pavia. We retrospectively ex-tracted the data of patients tested for PUA from October to December 2020. Demographic, clinical, and laboratory data were recorded. Of 469 patients, 42 tested positive for PUA (8.95%), while 427 (91.05%) tested negative. A positive PUA result had no significant impact on death (HR 0.53 CI [0.22–1.28] p-value 0.16) or ICU admission (HR 0.8; CI [0.25–2.54] p-value 0.70) in the Cox regression model, nor on length of stay in linear regression (estimate 1.71; SE 2.37; p-value 0.47). After adjusting for age, we found no significant correlation between urinary antigen positivity and variations in the WHO ordinal scale and laboratory markers at admission and after 14 days. We found that a positive PUA result was not frequent and had no impact on clinical outcomes or clinical improvement. Our results did not support the routine use of PUA tests to select COVID-19 patients who will benefit from antibiotic therapy.
AB - Despite low rates of bacterial co-infections, most COVID-19 patients receive antibiotic therapy. We hypothesized that patients with positive pneumococcal urinary antigens (PUAs) would benefit from antibiotic therapy in terms of clinical outcomes (death, ICU admission, and length of stay). The San Matteo COVID-19 Registry (SMACORE) prospectively enrolls patients admitted for COVID-19 pneumonia at IRCCS Policlinico San Matteo, Pavia. We retrospectively ex-tracted the data of patients tested for PUA from October to December 2020. Demographic, clinical, and laboratory data were recorded. Of 469 patients, 42 tested positive for PUA (8.95%), while 427 (91.05%) tested negative. A positive PUA result had no significant impact on death (HR 0.53 CI [0.22–1.28] p-value 0.16) or ICU admission (HR 0.8; CI [0.25–2.54] p-value 0.70) in the Cox regression model, nor on length of stay in linear regression (estimate 1.71; SE 2.37; p-value 0.47). After adjusting for age, we found no significant correlation between urinary antigen positivity and variations in the WHO ordinal scale and laboratory markers at admission and after 14 days. We found that a positive PUA result was not frequent and had no impact on clinical outcomes or clinical improvement. Our results did not support the routine use of PUA tests to select COVID-19 patients who will benefit from antibiotic therapy.
KW - Antibiotic therapy
KW - COVID-19
KW - Pneumococcal urinary antigen
KW - SARS-COV-2
KW - Streptococcus pneumoniae
UR - http://www.scopus.com/inward/record.url?scp=85112633144&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85112633144&partnerID=8YFLogxK
U2 - 10.3390/jpm11080762
DO - 10.3390/jpm11080762
M3 - Article
AN - SCOPUS:85112633144
VL - 11
JO - Journal of Personalized Medicine
JF - Journal of Personalized Medicine
SN - 2075-4426
IS - 8
M1 - 762
ER -