Biomarkers: Are They Useful in Severe Community-Acquired Pneumonia?

Pedro Póvoa; Melissa Pitrowsky; Gonçalo Guerreiro; Mariana B. Pacheco; Jorge I.F. Salluh

doi:10.1055/s-0043-1777771

Seminars in Respiratory and Critical Care Medicine, Table of Contents

Semin Respir Crit Care Med 2024; 45(02): 200-206
DOI: 10.1055/s-0043-1777771

Review Article

Biomarkers: Are They Useful in Severe Community-Acquired Pneumonia?

Pedro Póvoa

¹NOVA Medical School, Centre for Integrated Research in Health, New University of Lisbon, Lisbon, Portugal

²Research Unit of Clinical Epidemiology, Institute of Clinical Research, University of Southern Denmark, Centre for Clinical Epidemiology, Odense University Hospital, Odense, Denmark

³Department of Intensive Care, São Francisco Xavier Hospital, CHLO, Lisbon, Portugal

,

Melissa Pitrowsky

⁴Postgraduate Program of Internal Medicine, Federal University of Rio de Janeiro, (UFRJ), Rio de Janeiro, Brazil

,

Gonçalo Guerreiro

³Department of Intensive Care, São Francisco Xavier Hospital, CHLO, Lisbon, Portugal

,

Mariana B. Pacheco

⁵Medical School, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil

⁶D'Or Institute for Research and Education, Rio de Janeiro, Brazil

,

Jorge I.F. Salluh

⁴Postgraduate Program of Internal Medicine, Federal University of Rio de Janeiro, (UFRJ), Rio de Janeiro, Brazil

⁶D'Or Institute for Research and Education, Rio de Janeiro, Brazil

› Author Affiliations

Abstract

Community acquired pneumonia (CAP) is a prevalent infectious disease often requiring hospitalization, although its diagnosis remains challenging as there is no gold standard test. In severe CAP, clinical and radiologic criteria have poor sensitivity and specificity, and microbiologic documentation is usually delayed and obtained in less than half of sCAP patients. Biomarkers could be an alternative for diagnosis, treatment monitoring and establish resolution. Beyond the existing evidence about biomarkers as an adjunct diagnostic tool, most evidence comes from studies including CAP patients in primary care or emergency departments, and not only sCAP patients. Ideally, biomarkers used in combination with signs, symptoms, and radiological findings can improve clinical judgment to confirm or rule out CAP diagnosis, and may be valuable adjunctive tools for risk stratification, differentiate viral pneumonia and monitoring the course of CAP. While no single biomarker has emerged as an ideal one, CRP and PCT have gathered the most evidence. Overall, biomarkers offer valuable information and can enhance clinical decision-making in the management of CAP, but further research and validation are needed to establish their optimal use and clinical utility.

Keywords

Community-Acquired Pneumonia - Severe community – Acquired Pneumonia - Biomarkers - C-Reactive Protein - Procalcitonin - Intensive Care Unit

Full Text

References

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