tetano
Editor, Senior Moderator
J Med Virol
. 2020 Aug 18.
doi: 10.1002/jmv.26441. Online ahead of print.
Bacterial Infections and Patterns of Antibiotic Use in Patients with COVID-19
Alvaro Goncalves Mendes Neto[SUP] 1 [/SUP], Kevin Bryan Lo[SUP] 1 [/SUP], Ammaar Wattoo[SUP] 1 [/SUP], Grace Salacup[SUP] 1 [/SUP], Jerald Pelayo[SUP] 1 [/SUP], Robert DeJoy 3rd[SUP] 1 [/SUP], Ruchika Bhargav[SUP] 1 [/SUP], Fahad Gul[SUP] 1 [/SUP], Eric Peterson[SUP] 1 [/SUP], Jeri Albano[SUP] 1 [/SUP], Gabriel Patarroyo-Aponte[SUP] 1 2 3 [/SUP], Janani Rangaswami[SUP] 1 2 [/SUP], Zurab Azmaiparashvili[SUP] 1 [/SUP]
Affiliations
Abstract
Introduction: Bacterial coinfection is associated with poor outcomes in patients with viral pneumonia, but data on its role in the mortality of patients with COVID-19 is limited.
Methods: This is a single-center retrospective analysis of 242 patients with confirmed coronavirus disease 2019 (COVID-19) admitted to both intensive care and non-intensive care settings. Bacterial coinfection was determined by the presence of characteristic clinical features and positive culture results. Multivariable logistic regression was used to analyze the association of concomitant bacterial infection with inpatient death after adjusting for demographic factors and comorbidities. Antibiotic use pattern was also determined.
Results: Bacterial coinfection was detected in 46 (19%) patients. Genitourinary source was the most frequent, representing 57% of all coinfections. The overall mortality rate was 21%. Concomitant bacterial infections were independently associated with increased inpatient mortality (OR: 5.838; 95% CI: 2.647-12.876). Patients with bacterial coinfection were relatively older (71.35?11.20 vs. 64.78?15.23; p 0.006%). 67% of patients received antibiotic therapy, yet 72% did not have an obvious source of bacterial infection. There was a significantly higher rate of inpatient mortality in patients who received antibiotics compared to those who did not (30% vs. 5%; p<0.0001).
Conclusion: Bacterial coinfection in COVID-19 is associated with increased mortality. This article is protected by copyright. All rights reserved.
Keywords: SARS-CoV-2; antibiotic use; coinfections; inflammation; pandemics.
. 2020 Aug 18.
doi: 10.1002/jmv.26441. Online ahead of print.
Bacterial Infections and Patterns of Antibiotic Use in Patients with COVID-19
Alvaro Goncalves Mendes Neto[SUP] 1 [/SUP], Kevin Bryan Lo[SUP] 1 [/SUP], Ammaar Wattoo[SUP] 1 [/SUP], Grace Salacup[SUP] 1 [/SUP], Jerald Pelayo[SUP] 1 [/SUP], Robert DeJoy 3rd[SUP] 1 [/SUP], Ruchika Bhargav[SUP] 1 [/SUP], Fahad Gul[SUP] 1 [/SUP], Eric Peterson[SUP] 1 [/SUP], Jeri Albano[SUP] 1 [/SUP], Gabriel Patarroyo-Aponte[SUP] 1 2 3 [/SUP], Janani Rangaswami[SUP] 1 2 [/SUP], Zurab Azmaiparashvili[SUP] 1 [/SUP]
Affiliations
- PMID: 32808695
- DOI: 10.1002/jmv.26441
Abstract
Introduction: Bacterial coinfection is associated with poor outcomes in patients with viral pneumonia, but data on its role in the mortality of patients with COVID-19 is limited.
Methods: This is a single-center retrospective analysis of 242 patients with confirmed coronavirus disease 2019 (COVID-19) admitted to both intensive care and non-intensive care settings. Bacterial coinfection was determined by the presence of characteristic clinical features and positive culture results. Multivariable logistic regression was used to analyze the association of concomitant bacterial infection with inpatient death after adjusting for demographic factors and comorbidities. Antibiotic use pattern was also determined.
Results: Bacterial coinfection was detected in 46 (19%) patients. Genitourinary source was the most frequent, representing 57% of all coinfections. The overall mortality rate was 21%. Concomitant bacterial infections were independently associated with increased inpatient mortality (OR: 5.838; 95% CI: 2.647-12.876). Patients with bacterial coinfection were relatively older (71.35?11.20 vs. 64.78?15.23; p 0.006%). 67% of patients received antibiotic therapy, yet 72% did not have an obvious source of bacterial infection. There was a significantly higher rate of inpatient mortality in patients who received antibiotics compared to those who did not (30% vs. 5%; p<0.0001).
Conclusion: Bacterial coinfection in COVID-19 is associated with increased mortality. This article is protected by copyright. All rights reserved.
Keywords: SARS-CoV-2; antibiotic use; coinfections; inflammation; pandemics.