Impact of pneumococcal urinary antigen testing in covid-19 patients: Outcomes from the san matteo covid-19 registry (smacore)

Pietro Valsecchi, Marta Colaneri, Valentina Zuccaro, Erika Asperges, Filippo Costanzo, Bianca Mariani, Silvia Roda, Rita Minucci, Francesco Bertuccio, Elia Fraoilini, Matteo Bosio, Claudio Tirelli, Tiberio Oggionni, Angelo Corsico, Raffaele Bruno

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish
Article number762
JournalJournal of Personalized Medicine
Issue number8
Publication statusPublished - Aug 2021


  • Antibiotic therapy
  • COVID-19
  • Pneumococcal urinary antigen
  • SARS-COV-2
  • Streptococcus pneumoniae

ASJC Scopus subject areas

  • Medicine (miscellaneous)


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