• Annals of medicine · Jan 2023

    C-reactive protein and the neutrophil-to-lymphocyte ratio on admission predicting bacteraemia with COVID-19.

    • Yoshitaka Ueda, Naoto Yokogawa, Kengo Murata, and Tetsuya Kashiyama.
    • Department of Rheumatic Diseases, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan.
    • Ann. Med. 2023 Jan 1; 55 (2): 22786182278618.

    BackgroundBacteraemia can co-occur with COVID-19. The present study aimed to determine the cut-off value for C-reactive protein (CRP) and the neutrophil-to-lymphocyte ratio (NLR) for predicting bacteraemia in patients with COVID-19.MethodsPatients admitted to Tokyo Metropolitan Tama Medical Centre for COVID-19 treatment between 1 April 2020 and 30 October 2022 were included. Patients transferred from other hospitals and those whose CRP and/or neutrophil count was not measured at admission were excluded. Community-acquired bacteraemia was diagnosed if true bacteraemia was diagnosed in patients via a blood culture performed within 72 h of admission. The cut-off value for CRP and the NLR for community-acquired bacteraemia were determined using receiver operating characteristic analysis.ResultsAmong 2989 patients hospitalized for COVID-19 treatment, 19 received the diagnosis of community-acquired bacteraemia, for which CRP ≥ 6.3 was determined to be the cut-off value. The sensitivity and specificity of the cut-off was 89.5% and 73.3%, respectively. The NLR cut-off value was ≥ 7.7, which had a sensitivity and specificity of 84.2% and 84.0%, respectively.ConclusionsConsidering the possibility of the co-occurrence of bacteraemia with COVID-19, a blood culture should be performed when CRP is ≥ 6.3 or the NLR is ≥ 7.7.

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