{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T22:22:46Z","timestamp":1790202166953,"version":"4.1.0"},"reference-count":39,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2023,7,14]],"date-time":"2023-07-14T00:00:00Z","timestamp":1689292800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian Ministry of Health","award":["GR-2018-1236737"],"award-info":[{"award-number":["GR-2018-1236737"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>In COVID-19 patients, antibiotics overuse is still an issue. A predictive scoring model for the diagnosis of bacterial pneumonia at intensive care unit (ICU) admission would be a useful stewardship tool. We performed a multicenter observational study including 331 COVID-19 patients requiring invasive mechanical ventilation at ICU admission; 179 patients with bacterial pneumonia; and 152 displaying negative lower-respiratory samplings. A multivariable logistic regression model was built to identify predictors of pulmonary co-infections, and a composite risk score was developed using \u03b2-coefficients. We identified seven variables as predictors of bacterial pneumonia: vaccination status (OR 7.01; 95% CI, 1.73\u201328.39); chronic kidney disease (OR 3.16; 95% CI, 1.15\u20138.71); pre-ICU hospital length of stay \u2265 5 days (OR 1.94; 95% CI, 1.11\u20133.4); neutrophils \u2265 9.41 \u00d7 109\/L (OR 1.96; 95% CI, 1.16\u20133.30); procalcitonin \u2265 0.2 ng\/mL (OR 5.09; 95% CI, 2.93\u20138.84); C-reactive protein \u2265 107.6 mg\/L (OR 1.99; 95% CI, 1.15\u20133.46); and Brixia chest X-ray score \u2265 9 (OR 2.03; 95% CI, 1.19\u20133.45). A predictive score (C19-PNEUMOSCORE), ranging from 0 to 9, was obtained by assigning one point to each variable, except from procalcitonin and vaccine status, which gained two points each. At a cut-off of \u22653, the model exhibited a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 84.9%, 55.9%, 69.4%, 75.9%, and 71.6%, respectively. C19-PNEUMOSCORE may be an easy-to-use bedside composite tool for the early identification of severe COVID-19 patients with pulmonary bacterial co-infection at ICU admission. Its implementation may help clinicians to optimize antibiotics administration in this setting.<\/jats:p>","DOI":"10.3390\/jcm12144688","type":"journal-article","created":{"date-parts":[[2023,7,14]],"date-time":"2023-07-14T08:40:06Z","timestamp":1689324006000},"page":"4688","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["An Observational Study to Develop a Predictive Model for Bacterial Pneumonia Diagnosis in Severe COVID-19 Patients\u2014C19-PNEUMOSCORE"],"prefix":"10.3390","volume":"12","author":[{"given":"Eloisa Sofia","family":"Tanzarella","sequence":"first","affiliation":[{"name":"Dipartimento di Scienze Dell\u2019emergenza, Anestesiologiche e della Rianimazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel","family":"Vargas","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Cardiovascolari, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Menghini","sequence":"additional","affiliation":[{"name":"U.O.C. Terapia Intensiva OM e Hub Maxi Emergenze, Ospedale Maggiore Carlo Alberto Pizzardi, 40133 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Postorino","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Dell\u2019emergenza, Anestesiologiche e della Rianimazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Pozzana","sequence":"additional","affiliation":[{"name":"Dipartimento di Anestesia e Rianimazione, Ospedale Santa Maria Goretti, 04100 Latina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4493-7447","authenticated-orcid":false,"given":"Maria Sole","family":"Vallecoccia","sequence":"additional","affiliation":[{"name":"Anesthesia and Intensive Care Unit, Department of Emergency and Critical Care, Santa Maria Nuova Hospital, 50122 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco Lorenzo","family":"De Matteis","sequence":"additional","affiliation":[{"name":"Department of Medical Science, Surgery and Neurosciences, Cardiothoracic and Vascular Anesthesia and Intensive Care Unit, University of Siena, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Franchi","sequence":"additional","affiliation":[{"name":"Department of Medical Science, Surgery and Neurosciences, Cardiothoracic and Vascular Anesthesia and Intensive Care Unit, University of Siena, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4407-2631","authenticated-orcid":false,"given":"Amato","family":"Infante","sequence":"additional","affiliation":[{"name":"Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8136-038X","authenticated-orcid":false,"given":"Luigi","family":"Larosa","sequence":"additional","affiliation":[{"name":"Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6778-6894","authenticated-orcid":false,"given":"Maria Antonietta","family":"Mazzei","sequence":"additional","affiliation":[{"name":"Unit of Diagnostic Imaging, Department of Medical, Surgical and Neuro Sciences and of Radiological Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8135-6284","authenticated-orcid":false,"given":"Salvatore Lucio","family":"Cutuli","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Dell\u2019emergenza, Anestesiologiche e della Rianimazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4557-6308","authenticated-orcid":false,"given":"Domenico Luca","family":"Grieco","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Dell\u2019emergenza, Anestesiologiche e della Rianimazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Bisanti","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Dell\u2019emergenza, Anestesiologiche e della Rianimazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0666-8955","authenticated-orcid":false,"given":"Simone","family":"Carelli","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Dell\u2019emergenza, Anestesiologiche e della Rianimazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianmarco","family":"Lombardi","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Dell\u2019emergenza, Anestesiologiche e della Rianimazione, Fondazione Policlinico Universitario A. 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Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9519-8552","authenticated-orcid":false,"given":"Mario","family":"Tumbarello","sequence":"additional","affiliation":[{"name":"Dipartimento di Biotecnologie Mediche, Universit\u00e0 degli Studi di Siena, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3007-1670","authenticated-orcid":false,"given":"Massimo","family":"Antonelli","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Dell\u2019emergenza, Anestesiologiche e della Rianimazione, Fondazione Policlinico Universitario A. 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