Abstract
Objectives: We described the current incidence and risk factors of bacterial co-infection in hospitalized patients with COVID-19.
Methods: Observational cohort study was performed at the Hospital Clinic of Barcelona (February 2020-February 2021). All patients with COVID-19 who were admitted for >48 hours with microbiological sample collection and procalcitonin (PCT) determination within the first 48 hours were included.
Results: A total of 1125 consecutive adults met inclusion criteria. Co-infections were microbiologically documented in 102 (9.1%) patients. Most frequent microorganisms were Streptococcus pneumoniae (79%), Staphylococcus aureus (6.8%), and Haemophilus influenzae (6.8%). Test positivity was 1% (8/803) for blood cultures, 10.1% (79/780) for pneumococcal urinary antigen test, and 11.4% (15/132) for sputum culture. Patients with PCT higher than 0.2, 0.5, 1, and 2 ng/mL had significantly more co-infections than those with lower levels (p=0.017, p=0.031, p<0.001, and p<0.001, respectively). In multivariate analysis, oxygen saturation ≤94% (OR 2.47, CI 1.57-3.86), ferritin levels <338 ng/mL (OR 2.63, CI 1.69-4.07), and PCT higher than 0.2 ng/mL (OR 1.74, CI 1.11-2.72) were independent risk factors for co-infection at hospital admission owing to COVID-19.
Conclusions: Bacterial co-infection in patients hospitalized for COVID-19 is relatively common. However, clinicians could spare antibiotics in patients with PCT values <0.2, especially with high ferritin values and oxygen saturation >94%.
Keywords: COVID-19; SARS-CoV-2; antibiotics; bacterial infection; co-infection.
【저자키워드】 COVID-19, SARS-CoV-2, Antibiotics, Co-infection, Bacterial infection, 【초록키워드】 Test, ferritin, procalcitonin, risk factor, cohort study, Antigen, oxygen saturation, Patient, Co-infection, Hospital admission, incidence, bacterial co-infection, patients, Blood, Bacterial, microorganism, Haemophilus influenzae, Analysis, Streptococcus pneumoniae, Staphylococcus aureus, Barcelona, sputum culture, clinician, clinic, inclusion criteria, independent risk factor, cultures, MOST, pneumococcal, PCT, described, significantly more, was performed, hospitalized patient, 48 hour, ferritin level, microbiologically, patients hospitalized, patients with COVID-19, with COVID-19, 【제목키워드】 Co-infection, Hospital admission, patients with COVID-19,