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Bacterial infections in patients hospitalized with COVID-19

2021; Springer Science+Business Media; Volume: 17; Issue: 2 Linguagem: Inglês

10.1007/s11739-021-02824-7

1970-9366

Víctor Moreno‐Torres, Carmen de Mendoza, Sara de la Fuente, Enrique Sánchez, María Martínez‐Urbistondo, Jesús Herráiz, Andrea Gutiérrez, Ángela Gutiérrez, Carlos Hernández, Alejandro Callejas, C. Mainez, Ana Royuela, Valentín Cuervas‐Mons, Ana Fernández‐Cruz, Elena Múñez, Rosa Malo de Molina, Ilduara Pintos, Alberto Díaz de Santiago, Ana Ramos, Patricia Mills, Pedro Laguna, G. Vázquez, M. Valle, Alejandro Muñoz, Blanca Cantos, Jorge Calderón‐Parra, Alfonso Ángel-Moreno, I. Baños, E Montero, Maria Cristina Carreño, Yolanda Romero, Raúl Muñoz, Pablo Durán, Susana Mellor‐Pita, P. Tutor, M. Aguilar, G. Díaz, Carmen García, Barbara J. Jara, Rosalía Laporta, Manny Lazaro, Carlos López, Pablo Mínguez, Andrea Trisán, R. Carabias, Marta Erro, B. Agudo, Javier Aller, Raquel Benlloch, Miquel Blasco, Miguel Brito, Virginia Calvo, Marta Calvo, J. García Campos, Rosario Cazorla, Michele Cea, Hirune Cembrero, Esmeralda Colino, Stefano Corda, Sherene Magana Cruz, Gustavo Pozo, C. del Pozo, M. Elosua, María Espinosa, Cristina Fernández, Carlos Ferré, Manuel García‐Espantaleón, Eusebio García‐Izquierdo, B. Gil, Pablo Gómez‐Porro, Sara González, Isabel Tofiño González, Gonzalo Martı́nez de la Escalera, A. I. López, A. Losa, Mauro Marin, Ismael El Hajra, María Eugenia Marín Martínez, Constanza Maximiano, Míriam Méndez, Susana Mingo Santos, Cristina Mitroi, Beatriz Núñez, Pilar Rivera‐Ortega, J. Domínguez, N Pérez, Lina María Prieto, Lucía Relea, G. Rodríguez-Laiz, Julia Sabín, José Á. García-Sáenz, Antonio Sánchez, A. Ruiz, J. Sanz, Javier Segovia, L. Silva, Jorge Toquero, Marta Velasco, Serena Villaverde, Ane Andrés, Sara Ares-Blanco, Isabel Salcedo de Diego, Inmaculada Donate Carretero, Gabriela Escudero, Elizabeth Bello Expósito, Anjela Galan, Sonia García, José M. Gómez, Andrea Gutiérrez, V. Edith, Isabel Gutiérrez, Félix Alejandro Bello Martínez, Aura Isabel Mora, Ignacio Morrás, Alejandro Muñoz, Alfonso Valencia, Jesús María Vázquez, Ana-Maria Arias, José Luís Neyro, Andrea Duca, Miguel A García-Viejo, J. Ma Marcet Palau, Ana Roldan, Raquel Castejón, María Jesús Citores, Silvia Rosado, Juan A. Vargas, Piedad Ussetti,

Intensive Care Unit Cognitive Disorders

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.