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Incidence of co-infections and superinfections in hospitalized patients with COVID-19: a retrospective cohort study

2020; Elsevier BV; Volume: 27; Issue: 1 Linguagem: Inglês

10.1016/j.cmi.2020.07.041

1469-0691

Carolina García‐Vidal, Gemma Sanjuan, Estela Moreno-García, Pedro Puerta‐Alcalde, Nicole García-Pouton, Mariana Chumbita, Mariana Fernández-Pittol, Cristina Pitart, Alexy Inciarte, Marta Bodro, Laura Morata, Juan Ambrosioni, Ignacio Grafiá, Fernanda Meira, Irene Macaya, Celia Cardozo, Climent Casals‐Pascual, Adrián Téllez, Pedro Castro, Francesc Marco, Felipe García, Josep Mensa, José Antonio Martínez, Álex Soriano, Verónica Rico, Marta Hernández‐Meneses, Daiana Agüero, Berta Torres, Ana González-Cordón, Lorena de la Mora, Jhon Rojas, Laura Linares, Berta Fidalgo, Natàlia Rodríguez, David Nicolás, Laia Albiach, José Muñóz, Alex Almuedo-Riera, Daniel Camprubí, Ma Ángeles Marcos, Daniel Camprubí, Catia Cillóniz, Sara Fernández, José M. Nicolás, Antoni Torres,

Long-Term Effects of COVID-19

ObjectivesTo describe the burden, epidemiology and outcomes of co-infections and superinfections occurring in hospitalized patients with coronavirus disease 2019 (COVID-19).MethodsWe performed an observational cohort study of all consecutive patients admitted for ≥48 hours to the Hospital Clinic of Barcelona for COVID-19 (28 February to 22 April 2020) who were discharged or dead. We describe demographic, epidemiologic, laboratory and microbiologic results, as well as outcome data retrieved from electronic health records.ResultsOf a total of 989 consecutive patients with COVID-19, 72 (7.2%) had 88 other microbiologically confirmed infections: 74 were bacterial, seven fungal and seven viral. Community-acquired co-infection at COVID-19 diagnosis was uncommon (31/989, 3.1%) and mainly caused by Streptococcus pneumoniae and Staphylococcus aureus. A total of 51 hospital-acquired bacterial superinfections, mostly caused by Pseudomonas aeruginosa and Escherichia coli, were diagnosed in 43 patients (4.7%), with a mean (SD) time from hospital admission to superinfection diagnosis of 10.6 (6.6) days. Overall mortality was 9.8% (97/989). Patients with community-acquired co-infections and hospital-acquired superinfections had worse outcomes.ConclusionsCo-infection at COVID-19 diagnosis is uncommon. Few patients developed superinfections during hospitalization. These findings are different compared to those of other viral pandemics. As it relates to hospitalized patients with COVID-19, such findings could prove essential in defining the role of empiric antimicrobial therapy or stewardship strategies.