Time since symptom onset modifies the systemic inflammatory profile at Community-acquired Pneumonia (CAP) diagnosis. This information has relevant clinical implications for management, and it should be taken into account in the design of future clinical trials. In early presenters, CRP was significantly lower, whereas PCT, IL-6, and IL-8 were higher. Nonearly presenters showed significantly lower PCT, IL-6, and IL-8 levels. In the validation cohort, CRP and PCT exhibited identical patterns: CRP levels were 36.4% greater in patients with 3 or more days since onset of symptoms than in those with less than 3 days since symptom onset in the derivation cohort and 38.2% in the validation cohort.

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