ABSTRACT
Introduction We evaluated the prevalence, aetiologies and antibiotic resistance patterns of bacterial infections in hospitalized patients with laboratory-confirmed SARS-CoV-2. We also investigated comorbidities, risk factors, and the mortality rate in COVID-19 patients with bacterial infections. Methods This retrospective observational study evaluated medical records of 7249 randomly selected patients with COVID-19 admitted to three clinical centres between January 1 2021 and February 16, 2022. A total of 6478 COVID-19 patients met the eligibility criteria for analysis. Results The mean age of the patients with SARS-CoV-2 and bacterial infections was 68.6 ± 15.5 years (range: 24 to 94 years). The majority of patients (68.7%) were older than 65 years. The prevalence of bacterial infections among hospitalized COVID-19 patients was 12.9%, most of them being hospital-acquired (11.5%). Bloodstream (37.7%) and respiratory tract infections (25.6%) were the most common bacterial infections. Klebsiella pneumoniae and Acinetobacter baumannii caused 25.2% and 23.6% of all bacterial infections, respectively. Carbapenem-resistance in Enterobacterales, A. baumannii, and Pseudomonas aeruginosa were 72.6%, 93.7%, and 69.1%. Age >60 years and infections caused by ≥3 pathogens were significantly more prevalent among deceased patients compared to survivors (p<0.05). Furthermore, 95% of patients who were intubated developed ventilator-associated pneumonia. The overall in-hospital mortality rate of patients with SARS-CoV-2 and bacterial infections was 51.6%, while 91.7% of patients who required invasive mechanical ventilation died. Conclusions Our results reveal a striking association between healthcare-associated bacterial infections as an important complication of COVID-19 and fatal outcomes.
ABSTRACT
Background/Aim. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a global threat and a huge problem for our community. There are so many open questions. The aim of this study was to establish the frequency of gastrointestinal (GI) symptoms in hospitalized patients with infection caused by this virus (coronavirus disease-19 – COVID-19), but also to compare if patients with GI symptoms have a higher computed tomography (CT) scan severity score of interstitial pneumonia (IP) compared to patients with COVID-19 without GI symptoms. Methods. Our database comprised 322 patients with COVID-19 who were divided into two groups, patients with and without GI symptoms. All information was taken from anamnestic data and patients’ history, followed by statistical analysis. Results. Thorax CT scans of 206 patients (63.9%) were described as bilateral IP, of which 76 CT scans (36.9%) were described by radiologists as the peak of infection. Moreover, 130 patients (40.4%) had GI symptoms, and even 58 out of 130 patients (44.6%) reported GI symptoms as the first manifestation of COVID-19 infection. The most commonly reported one was the lack of appetite (73 patients or 56.15%). Furthermore, 65 (50%) patients reported diarrhea, 25 (19.2%) patients reported nausea and vomiting, and 9 (6.9%) patients reported abdominal pain. In addition, among patients with bilateral IP and GI tract symptoms, 31 (40.79%) of them did not have a higher CT scan severity score at the peak of the disease compared to the patients without GI symptoms (45 of them or 59.2%), (p = 0.704). Conclusion. GI symptoms often are the first manifestation of COVID-19. Therefore, every patient with newly formed digestive tract symptoms should be tested for COVID-19. On the other hand, GI symptoms do not indicate COVID-19 patients will have a severe form of IP. © 2022 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.