High Serum Procalcitonin Concentrations in Patients With Hemorrhagic Fever With Renal Syndrome Caused by Hantaan Virus

This study analyzed the significance of procalcitonin (PCT) in patients with hemorrhagic fever with renal syndrome (HFRS) caused by Hantaan virus. The demographics and clinical and laboratory data including PCT at hospital admission in 146 adults with HFRS were retrospectively analyzed. PCT level was significantly higher in severe patients ( = 72) than in mild patients ( = 74, < 0.001) and independently associated with disease severity (OR 2.544, 95% CI 1.330-4.868, = 0.005). PCT had an area under the receiver operating characteristic curve (AUC) value of 0.738 (95% CI 0.657-0.820, < 0.001) for predicting severity. PCT level was significantly increased in patients with bacterial infection ( = 87) compared with those without (n = 59, = 0.037) and associated with bacterial infection (OR 1.685, 95% CI 1.026-2.768, = 0.039). The AUC value of PCT for predicting bacterial infection was 0.618 (95% CI 0.524-0.711, = 0.016). PCT level was significantly elevated in non-survivors ( = 13) compared with survivors ( = 133, < 0.001) and independently associated with mortality (OR 1.075, 95% CI 1.003-1.152, = 0.041). The AUC value of PCT for predicting mortality was 0.819 (95% CI 0.724-0.914, < 0.001). PCT concentrations at admission would be predictive of disease severity, secondary bacterial infection and mortality in patients with HFRS caused by Hantaan virus.