Sobreinfecciones intrahospitalarias y su relación con la mortalidad en pacientes obesos o diabéticos con COVID-19 críticamente enfermos

Abstract

Objective

To analyze hospital-acquired superinfections and their relationship with mortality in critically ill obese or diabetic patients with COVID-19.

Design

Correlational analysis in an intensive care unit of the public network of Barranquilla (Colombia) between January and December 2021.

Patients

Patients with obesity or type 2 diabetes mellitus and severe SARS-CoV-2 pneumonia requiring cultures of bronchial secretion, blood cultures, and urine cultures 48 h after admission.

Measurements

We compared the presence and absence of superinfection using the Mann-Whitney U, Chi-square, and Fischer tests. To evaluate mortality, it was evaluated using the Kaplan-Meier method, and instantaneous ratio risks were determined.

Results

Seventy-eight patients with a median age of 61 years (51.5-67.8) were included. Superinfection in obese people was 51.6% (n = 16) and diabetics 61.3% (n = 19). On the fifth in-hospital day, in-hospital superinfections increased. A total of 31 microorganisms isolated: 16.1% gram-positive, 80.6% gram-negative and 3.2% yeast. Overall mortality was 85.9% (n = 67). Superinfection was associated with an increase in mortality during the hospital stay (HR: 1.89; 95% CI: 1.13-3.15; P = .015) and in the intensive care unit (HR: 1.72; 95% CI: 1.02-2.89; P = .040).

Conclusions

In critically ill obese or diabetic patients, the presence of in-hospital superinfections represents a fatal complication during the hospital stay; however, no statistically significant differences were found between mortality associated with the presence or absence of superinfection.