Importance There is a need to develop tools to differentiate COVID-19 from bacterial pneumonia at the time of clinical presentation before diagnostic testing is available.
Objective To determine if the Ferritin-to-Procalcitonin ratio (F/P) can be used to differentiate COVID-19 from bacterial pneumonia.
Design This case-control study compared patients with either COVID-19 or bacterial pneumonia, admitted between March 1 and May 31, 2020. Patients with COVID-19 and bacterial pneumonia co-infection were excluded.
Setting A multicenter study conducted at three hospitals that included UCHealth and Phoebe Putney Memorial Hospital in the United States, and Yichang Central People’s Hospital in China.
Participants A total of 242 cases with COVID-19 infection and 34 controls with bacterial pneumonia.
Main Outcomes and Measures The F/P in patients with COVID-19 or with bacterial pneumonia were compared. Receiver operating characteristic analysis determined the sensitivity and specificity of various cut-off F/P values for the diagnosis of COVID-19 versus bacterial pneumonia.
Results Patients with COVID-19 pneumonia had a lower mean age (57.11 vs 64.4 years, p=0.02) and a higher BMI (30.74 vs 27.15 kg/m2, p=0.02) compared to patients with bacterial pneumonia. Cases and controls had a similar proportion of women (47% vs 53%, p=0.5) and COVID-19 patients had a higher prevalence of diabetes mellitus (32.6% vs 12%, p=0.01). The median F/P was significantly higher in patients with COVID-19 (4037.5) compared to the F/P in bacterial pneumonia (802, p<0.001). An F/P ≥ 877 used to diagnose COVID-19 resulted in a sensitivity of 85% and a specificity of 56%, with a positive predictive value of 93.2%, and a likelihood ratio of 1.92. In multivariable analyses, an F/P ≥ 877 was associated with greater odds of identifying a COVID-19 case (OR: 11.27, CI: 4-31.2, p<0.001).
Conclusions and Relevance An F/P ≥ 877 increases the likelihood of COVID-19 pneumonia compared to bacterial pneumonia. Further research is needed to determine if obtaining ferritin and procalcitonin simultaneously at the time of clinical presentation has improved diagnostic value. Additional questions include whether an increased F/P and/or serial F/P associates with COVID-19 disease severity or outcomes.
Competing Interest Statement
戈尔迪·霍恩（Goldie Hawn）曾因影片《仙人掌花》（Cactus Flower）获最佳女配角奖，她的奖杯坐落在一个非常富有禅宗气息的地方——她的“印度房间”，她常在这里冥想。她的小金人并不是唯一一个和主人有共鸣的奖杯，罗素-克洛（Russell Crowe）曾在影片《角斗士》（Gladiator）中身着罗马战士裙装，扮演了一个威猛、极具感情和个性的古罗马战士--司令官马克西姆斯，他的奖杯放在鸡舍中，因为克洛相信小金人能够保佑母鸡下出更大的鸡蛋。
Total Program Cost: $181,500 in either Philadelphia or San Francisco
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Last week, Lu was appointed director of the office for Beijing's Leading Group of Promoting Beijing-Tianjin-Hebei Integration Development, a move to accelerate Beijing's moves to coordinate with Tianjin and Hebei province.
Well, what you do makes me cry at night. You grown ups say you love us. I challenge you, please make your actions reflect your words. Thank you for listening. 然而，你们所做的事让我在夜晚哭泣，你们成年人说你们爱我们，我不会再相信了，因为只有行动和语言的合一，才是找回信任和未来的唯一方法！谢谢！
Who is hosting the 2014 Oscars?
"Demolitions are now becoming increasingly terrible. I am willing to ask a question very seriously as a CPPCC National Committee member: Can we not pay so much attention to GDP? Can we choose to slow down the speed of economic development?" CUI YONGYUAN, member of the CPPCC National Committee and TV host
当时，身为首席执行官的库克也承受着压力，因为苹果除了从iPhone攫取利润之外，缺乏清晰的产品开发方向。维权投资者嗅到了血腥，开始围攻这家公司，打头的是大卫?艾因霍恩(David Einhorn)，接着是卡尔?伊坎(Carl Icahn)，他们游说改变苹果的经营和财务管理方式。伊坎施压要求苹果筹集巨额债务，向股东返还1500亿美元，并敦促苹果发布包括电视机在内的更多产品。
而在科隆游戏展上正式宣布的特色作品中，《寂静岭》（Silent Hills）的最新续集赫然在列。这是科乐美（Konami）最为畅销的恐怖题材游戏（还据此改编成了两部电影）。世界级游戏和电影专家，《合金装备5：幻痛》（Metal Gear Solid V: The Phantom Pain）的制作者小岛秀夫，以及《环太平洋》（Pacific Rim）的导演吉尔莫o德尔o托罗在这部游戏中强强联手。曾出演美剧《行尸走肉》（The Walking Dead）的影星诺曼o瑞杜斯将在游戏中担纲主角。
Strong in many categories, but without quite managing to be a front runner in any. Perhaps Timothee Chalamet's performance is its best chance of awards success.
Effectively strengthening environmental protection
That's particularly striking in Brazil, with its highly mixed population that has more blacks than any country with the exception of Nigeria. More than half of Brazil's population self-identified themselves as black or of mixed-race in the 2010 census.
“If lenders are too optimistic during market booms and too pessimistic in downturns, that could be a good reason for authorities to set conservative capital requirements,” he suggests. “Higher haircuts might dampen the initial run-ups, but they could also dampen the subsequent fallouts when tides turn.”