Prevalence of secondary infections and association with mortality rates of hospitalized COVID-19 patients.

IF 1.5 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Annals of Saudi Medicine Pub Date : 2023-07-01 Epub Date: 2023-08-03 DOI:10.5144/0256-4947.2023.243
Khalifa Binkhamis, Alanoud S Alhaider, Ayah K Sayed, Yara K Almufleh, Ghadah A Alarify, Norah Y Alawlah
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引用次数: 0

Abstract

Background: ICU and other patients hospitalized with corona-virus disease 2019 (COVID-19) are more susceptible to secondary infections. Undetected secondary infections tend to have a severe clinical impact, associated with prolonged hospitalization and higher rates of inpatient mortality.

Objectives: Estimate the prevalence of secondary infections, determine the frequency of microbial species detected at different body sites, and measure the association between secondary infections and outcomes among hospitalized COVID-19 patients.

Design: Cross-sectional analytical study.

Setting: Tertiary care center in Riyadh PATIENTS AND METHODS: Data were collected through retrospective chart review of hospitalized COVID-19 patients >18 years old from March 2020 until May 2022 at King Saud University Medical City (27 months). Rates of secondary infections among hospitalized COVID-19 patients were described and data on clinical outcomes (intensive care admission, invasive management procedures and mortality) was collected.

Main outcome measures: Features and rates of infection and mortality.

Sample size: 260 RESULTS: In total, 24.2% of the study population had secondary infections. However, only 68.8% of patients had secondary infection testing, from which 35.2% had a confirmed secondary infection. These patients had a significantly higher prevalence of diabetes mellitus (P<.0001) and cardiovascular diseases (P=.001). The odds of ICU admissions (63.3%) among secondarily infected patients was 8.4 times higher compared to patients with only COVID-19 infection (17.3%). Secondarily infected patients were more likely to receive invasive procedures (OR=5.068) and had a longer duration of hospital stay compared to COVID-19 only patients. Overall mortality was 16.2%, with a predominantly higher proportion among those secondarily infected (47.6% vs 6.1%) (OR=14.015). Bacteria were the most commonly isolated organisms, primarily from blood (23.3%), followed by fungal isolates, which were mostly detected in urine (17.2%). The most detected organism was Candida albicans (17.2%), followed by Escherichia coli (9.2%), Klebsiella pneumoniae (9.2%) and Pseudomonas aeruginosa (9.2%).

Conclusion: Secondary infections were prevalent among hospitalized COVID-19 patients. Secondarily infected patients had longer hospital stay, higher odds of ICU admission, mortality, and invasive procedures.

Limitation: Single-center study, retrospective design and small sample size.

Conflict of interest: None.

新冠肺炎住院患者的二次感染患病率及其与死亡率的关系。
背景:ICU和其他2019冠状病毒病(新冠肺炎)住院患者更容易发生二次感染。未检测到的继发感染往往具有严重的临床影响,与住院时间延长和住院死亡率较高有关。目的:估计二次感染的流行率,确定在不同身体部位检测到的微生物种类的频率,并测量新冠肺炎住院患者二次感染与结果之间的关系。设计:横断面分析研究。环境:利雅得三级护理中心患者和方法:通过回顾性图表审查收集2020年3月至2022年5月在沙特国王大学医疗城(27个月)住院的18岁以上新冠肺炎患者的数据。描述了住院新冠肺炎患者的二次感染率,并收集了临床结果数据(重症监护入院、侵入性管理程序和死亡率)。主要结果指标:感染和死亡率的特点和比率。样本量:260结果:总的来说,24.2%的研究人群有继发感染。然而,只有68.8%的患者进行了二次感染检测,其中35.2%的患者确诊为二次感染。这些患者的糖尿病患病率显著较高(PP=.001)。与仅感染新冠肺炎的患者(17.3%)相比,二次感染患者入住ICU的几率(63.3%)高8.4倍。二次感染的患者更有可能接受侵入性手术(OR=5.068),住院时间也更长患者。总死亡率为16.2%,二次感染者的比例更高(47.6%对6.1%)(OR=14.015)。细菌是最常见的分离生物,主要来自血液(23.3%),其次是真菌分离物,主要在尿液中检测到(17.2%)。检测最多的生物是白色念珠菌(17.2%,肺炎克雷伯氏菌(9.2%)和绿脓杆菌(9.2%。二次感染患者的住院时间更长,入住重症监护室的几率更高,死亡率和侵入性手术也更高。局限性:单中心研究,回顾性设计,样本量小。利益冲突:无。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Annals of Saudi Medicine
Annals of Saudi Medicine 医学-医学:内科
CiteScore
2.80
自引率
0.00%
发文量
44
审稿时长
4-8 weeks
期刊介绍: The Annals of Saudi Medicine (ASM) is published bimonthly by King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. We publish scientific reports of clinical interest in English. All submissions are subject to peer review by the editorial board and by reviewers in appropriate specialties. The journal will consider for publication manuscripts from any part of the world, but particularly reports that would be of interest to readers in the Middle East or other parts of Asia and Africa. Please go to the Author Resource Center for additional information.
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