Review Article

Biomarkers of Community-Acquired Pneumonia: A Key to Disease Diagnosis and Management

Table 4

Candidate biomarkers associated with CAP severity.

Study [Ref.]Study designPatientsMortality (at 28 – 30 days follow-up)
Prediction rules used for assessing the severity of CAP
Target proteins

Christ-Crain et al, 2006 [59]prospective observational study302
adults
survivors (n = 264),
non-survivors (n = 38)
PSI class:
I, II and III (n = 120),
IV (n = 130),
V (n = 52)
mid regional proADM, CRP,
PCT,
WBC

Kruger et al., 2010 [60]multicenter prospective observational study CAPNETZ728
adults
survivors (n =691),
non-survivors (n =37):
within 28 days (n = 18), and within 180 days (n = 19)
CRB-65 score:
0 (n = 306),
1 (n = 317),
2 (n = 90),
3 (n = 15),
4 (n = 0)
mid regional proADM, mid regional proANP, copeptin,
CT-ET-1,
PCT,
CRP

Espana et al., 2015 [61]prospective observational study491
adults
survivors (n = 456),
non-survivors (n = 35)
PSI I-III (n = 325),
CURB-65 score 0-1 (n = 284),
SCAP score 0-1 (n = 353)
proADM,
PCT,
CRP

Gutbier et al., 2018 [62]multicenter prospective observational study CAPNETZ
prospective observational ancillary study of CAPNETZ and PROGRESS
148, and 395 adults (independent cohorts)cohort 1 (CAPNETZ):
survivors (n = 74),
non-survivors (n = 74);
CRB-65 score:
0 (n = 8),
1 (n = 58),
2 (n = 66),
3 (n = 16),
4 (n = 0)
cohort 2 (PROGRESS):
survivors (n = 376),
non-survivors (n = 19);
CRB-65 score:
0 (n = 130),
1 (n = 124),
2 (n = 90),
3 (n = 39),
4 (n = 11),
5 (n = 1)
Ang-1,
Ang-2

Dai et al., 2015
[63]
retrospective analysis in small cohort52 childrennot reportedLPS

Huang et al., 2014
[65]
proteomic study to identify and validate markers390 children (identification)
293 children (validation)
cohort 1 (identification):
non-severe CAP (n = 96),
severe CAP (n = 76),
very severe CAP (n = 32),
healthy controls (n = 186).
cohort 2 with respiratory distress (validation):
pneumonia (n = 238),
malaria (n = 41),
pneumonia and malaria (n = 14)
NGAL/Lpc-2, haptoglobin
CRP,
vWF

Bacci et al., 2015
[66]
prospective observational study in small cohort27
adults
survivors within 7 days (n =19),
non-survivors within 7 days (n = 7):
survivors within 28 days (n = 16),
non-survivors within 28 days (n = 10)
prediction rules CURB-65 score and CRB score: cohort data not reported
IL-1,
IL-6,
TNF-a,
CRP,
homocystein

Kim et al., 2016
[67]
prospective observational study362
adults
survivors (n = 324),
non-survivors (n = 38)
PSI class:
I, II and III (n = 186),
IV (n = 128),
V (n = 48)
NGAL/Lpc-2,
PCT

Nikaido
2015
[69]
prospective observational study in small cohort41
adults
A-DROP score:
mild pneumonia A-DROP 0 – 1 (n = 17),
severe pneumonia A-DROP 2–5 (n = 13),
healthy volunteers (n = 11)
Syndecan-4 (SYN4)

Esposito et al, 2016
[70]
prospective observational study110 childrensevere CAP (n = 84)NGAL/Lpc-2,
SYN4,
CRP

Abbreviations:
SCAP - severe community-acquired pneumonia score,
CURB65 score (Confusion, Uremia, Respiratory rate, Blood pressure, age 65 years),
A-DROP scoring system (Age, Dehydration, Respiratory rate, Orientation, blood Pressure).