Inflammatory biomarkers are associated with aetiology and predict outcomes in community-acquired pneumonia: results of a 5-year follow-up cohort study

• Published in: ERJ open research Vol. 5; no. 1; p. 14
• Main Authors: Siljan, William W, Holter, Jan C, Michelsen, Annika E, Nymo, Ståle H, Lauritzen, Trine, Oppen, Kjersti, Husebye, Einar, Ueland, Thor, Mollnes, Tom E, Aukrust, Pål, Heggelund, Lars
• Format: Journal Article
• Language: English
• Published: England European Respiratory Society 01-02-2019
• Subjects: Original
• ISSN: 2312-0541; 2312-0541
• DOI: 10.1183/23120541.00014-2019

Biomarkers may facilitate clinical decisions in order to guide antimicrobial treatment and prediction of prognosis in community-acquired pneumonia (CAP). We measured serum C-reactive protein, procalcitonin (PCT) and calprotectin levels, and plasma pentraxin 3 (PTX3) and presepsin levels, along with whole-blood white cell counts, at three time-points, and examined their association with microbial aetiology and adverse clinical outcomes in CAP.
Blood samples were obtained at hospital admission, clinical stabilisation and 6-week follow-up from 267 hospitalised adults with CAP. Adverse short-term outcome was defined as intensive care unit admission and 30-day mortality. Long-term outcome was evaluated as 5-year all-cause mortality.
Peak levels of all biomarkers were seen at hospital admission. Increased admission levels of C-reactive protein, PCT and calprotectin were associated with bacterial aetiology of CAP, while increased admission levels of PCT, PTX3 and presepsin were associated with adverse short-term outcome. In univariate and multivariate regression models, white blood cells and calprotectin at 6-week follow-up were predictors of 5-year all-cause mortality.
Calprotectin emerges as both a potential early marker of bacterial aetiology and a predictor for 5-year all-cause mortality in CAP, whereas PCT, PTX3 and presepsin may predict short-term outcome.