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

Pedro Póvoa, Melissa Pitrowsky, Gonçalo Guerreiro, Mariana B Pacheco, Jorge I F Salluh

Seminars in respiratory and critical care medicine 2024 Apr

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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. Thieme. All rights reserved.

Citation

Pedro Póvoa, Melissa Pitrowsky, Gonçalo Guerreiro, Mariana B Pacheco, Jorge I F Salluh. Biomarkers: Are They Useful in Severe Community-Acquired Pneumonia? Seminars in respiratory and critical care medicine. 2024 Apr;45(2):200-206