Journal
INTERNAL AND EMERGENCY MEDICINE
Volume 17, Issue 2, Pages 431-438Publisher
SPRINGER-VERLAG ITALIA SRL
DOI: 10.1007/s11739-021-02824-7
Keywords
COVID-19 pneumonia; Bacterial infections; Steroids
Categories
Funding
- Instituto de Salud Carlos III [PI16-01480]
Ask authors/readers for more resources
Bacterial infections occurred in 8.5% of COVID-19 patients hospitalized during the first wave of the pandemic, with urinary tract infections, bacteremia, and pneumonia being the most common types. Older age, neurological disease, prior immunosuppression, and ICU admission were independent predictors of bacterial infections. Mortality was higher in patients with bacterial infections, but the severity of baseline COVID-19 rather than the presence of bacterial infections contributed more to mortality. The use of steroids or steroids plus tocilizumab might improve survival in this patient population.
Bacterial infections may complicate the course of COVID-19 patients. The rate and predictors of bacterial infections were examined in patients consecutively admitted with COVID-19 at one tertiary hospital in Madrid between March 1st and April 30th, 2020. Among 1594 hospitalized patients with COVID-19, 135 (8.5%) experienced bacterial infectious events, distributed as follows: urinary tract infections (32.6%), bacteremia (31.9%), pneumonia (31.8%), intra-abdominal infections (6.7%) and skin and soft tissue infections (6.7%). Independent predictors of bacterial infections were older age, neurological disease, prior immunosuppression and ICU admission (p < 0.05). Patients with bacterial infections who more frequently received steroids and tocilizumab, progressed to lower Sap02/FiO2 ratios, and experienced more severe ARDS (p < 0.001). The mortality rate was significantly higher in patients with bacterial infections as compared to the rest (25% vs 6.7%, respectively; p < 0.001). In multivariate analyses, older age, prior neurological or kidney disease, immunosuppression and ARDS severity were associated with an increased mortality (p < 0.05) while bacterial infections were not. Conversely, the use of steroids or steroids plus tocilizumab did not confer a higher risk of bacterial infections and improved survival rates. Bacterial infections occurred in 8.5% of patients hospitalized with COVID-19 during the first wave of the pandemic. They were not independently associated with increased mortality rates. Baseline COVID-19 severity rather than the incidence of bacterial infections seems to contribute to mortality. When indicated, the use of steroids or steroids plus tocilizumab might improve survival in this population.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available