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

Autor:	Póvoa P; NOVA Medical School, Centre for Integrated Research in Health, New University of Lisbon, Lisbon, Portugal.; Research Unit of Clinical Epidemiology, Institute of Clinical Research, University of Southern Denmark, Centre for Clinical Epidemiology, Odense University Hospital, Odense, Denmark.; Department of Intensive Care, São Francisco Xavier Hospital, CHLO, Lisbon, Portugal., Pitrowsky M; Postgraduate Program of Internal Medicine, Federal University of Rio de Janeiro, (UFRJ), Rio de Janeiro, Brazil., Guerreiro G; Department of Intensive Care, São Francisco Xavier Hospital, CHLO, Lisbon, Portugal., Pacheco MB; Medical School, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.; D'Or Institute for Research and Education, Rio de Janeiro, Brazil., Salluh JIF; Postgraduate Program of Internal Medicine, Federal University of Rio de Janeiro, (UFRJ), Rio de Janeiro, Brazil.; D'Or Institute for Research and Education, Rio de Janeiro, Brazil.
Jazyk:	angličtina
Zdroj:	Seminars in respiratory and critical care medicine [Semin Respir Crit Care Med] 2024 Apr; Vol. 45 (2), pp. 200-206. Date of Electronic Publication: 2024 Jan 09.
DOI:	10.1055/s-0043-1777771
Abstrakt:	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. Competing Interests: None declared. (Thieme. All rights reserved.)
Databáze:	MEDLINE
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