An overview of procalcitonin in Crimean-Congo hemorrhagic fever: clinical diagnosis, follow-up, prognosis and survival rates

Abstract

Objectives: This study investigates whether a diagnostic threshold value of procalcitonin exists in Crimean-Congo hemorrhagic fever (CCHF), while also determining the correlation between serum procalcitonin and routine diagnostic laboratory markers, monitoring changes in procalcitonin levels over time during hospitalization, and exploring the effect of procalcitonin levels on survival rates. Methods: A total of 161 patients, including 100 with laboratory-confirmed diagnosis of CCHF and 61 as a control group, were retrospectively investigated. Receiver operating characteristics (ROC) curve analysis was performed to evaluate the contribution of procalcitonin when diagnosing the onset in CCHF patients. Procalcitonin levels were measured with Diazyme latex-enhanced immunoturbidimetric method in Roche Cobas C501 analyzer. A Mann-Whitney U-test was applied to compare the groups, a Mantel-Haenszel (log-rank) test was used to calculate for graphic of original individual patient time-to-event data, and a Kaplan-Meier survival curve was plotted. Results: A ROC curve analysis identified a best predictive procalcitonin level cut-off point of 0.560 mu g/L, with a specificity of 97% and sensitivity of 27% for CCHF. The highest levels of procalcitonin were measured on day 2 during the follow-up throughout and on the 5th day peaked for a second time, lower than the first. Conclusions: Procalcitonin may serve as prognostic indicator and an auxiliary biomarker to rule out of CCHF.