Predictive values of procalcitonin for coinfections in patients with COVID-19: a systematic review and meta-analysis

Objectives To assess the ability of procalcitonin (PCT)—a promising marker for coinfections—to predict coinfections in patients with COVID-19. Methods In this systematic review and meta-analysis, PubMed, Embase, Web of Science, Cochrane, the China National Knowledge Infrastructure (CNKI), and Wanfang were searched to identify eligible studies (up to August 30, 2021). Articles that reported the predictive value of PCT for coinfections in patients with COVID-19 were included. Individual and pooled sensitivities and specificities were reported, and I 2 was used to test heterogeneity. This study was prospectively registered on the International Prospective Register of Systematic Reviews (PROSPERO) database (registration number: CRD42021283344). Results Five studies involving a total of 2775 patients reported the predictive value of PCT for coinfections in patients with COVID-19. The sensitivity, specificity, and area under the curve of PCT in predicting coinfections in the pooled studies were 0.60 (95% CI 0.35–0.81, I 2 = 88.85), 0.71 (95% CI 0.58–0.81, I 2 = 87.82), and 0.72(95% CI 0.68–0.76) respectively. Conclusions Although PCT has limited predictive value for coinfections in patients with COVID-19, lower PCT levels seem to indicate a decreased probability of having a coinfection.