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Impact of Pneumococcal Urinary Antigen Testing in COVID-19 Patients: Outcomes from the San Matteo COVID-19 Registry (SMACORE).
Valsecchi, Pietro; Colaneri, Marta; Zuccaro, Valentina; Asperges, Erika; Costanzo, Filippo; Mariani, Bianca; Roda, Silvia; Minucci, Rita; Bertuccio, Francesco; Fraolini, Elia; Bosio, Matteo; Tirelli, Claudio; Oggionni, Tiberio; Corsico, Angelo; Bruno, Raffaele.
  • Valsecchi P; Division of Infectious Diseases I, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy.
  • Colaneri M; Division of Infectious Diseases I, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy.
  • Zuccaro V; Division of Infectious Diseases I, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy.
  • Asperges E; Division of Infectious Diseases I, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy.
  • Costanzo F; Division of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy.
  • Mariani B; Unit of Microbiology and Virology, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy.
  • Roda S; Division of Infectious Diseases I, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy.
  • Minucci R; Faculty of Medicine, University of Pavia, 27100 Pavia, Italy.
  • Bertuccio F; Division of Chest Medicine, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy.
  • Fraolini E; Division of Chest Medicine, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy.
  • Bosio M; Division of Chest Medicine, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy.
  • Tirelli C; Division of Chest Medicine, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy.
  • Oggionni T; Division of Chest Medicine, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy.
  • Corsico A; Division of Chest Medicine, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy.
  • Bruno R; Department of Clinical, Surgical, Diagnostic, and Paediatric Sciences, University of Pavia, 27100 Pavia, Italy.
J Pers Med ; 11(8)2021 Jul 31.
Article in English | MEDLINE | ID: covidwho-1335139
ABSTRACT
Despite low rates of bacterial co-infections, most COVID-19 patients receive antibiotic therapy. We hypothesized that patients with positive pneumococcal urinary antigens (PUAs) would benefit from antibiotic therapy in terms of clinical outcomes (death, ICU admission, and length of stay). The San Matteo COVID-19 Registry (SMACORE) prospectively enrolls patients admitted for COVID-19 pneumonia at IRCCS Policlinico San Matteo, Pavia. We retrospectively extracted the data of patients tested for PUA from October to December 2020. Demographic, clinical, and laboratory data were recorded. Of 469 patients, 42 tested positive for PUA (8.95%), while 427 (91.05%) tested negative. A positive PUA result had no significant impact on death (HR 0.53 CI [0.22-1.28] p-value 0.16) or ICU admission (HR 0.8; CI [0.25-2.54] p-value 0.70) in the Cox regression model, nor on length of stay in linear regression (estimate 1.71; SE 2.37; p-value 0.47). After adjusting for age, we found no significant correlation between urinary antigen positivity and variations in the WHO ordinal scale and laboratory markers at admission and after 14 days. We found that a positive PUA result was not frequent and had no impact on clinical outcomes or clinical improvement. Our results did not support the routine use of PUA tests to select COVID-19 patients who will benefit from antibiotic therapy.
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Full text: Available Collection: International databases Database: MEDLINE Language: English Year: 2021 Document Type: Article Affiliation country: Jpm11080762

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Full text: Available Collection: International databases Database: MEDLINE Language: English Year: 2021 Document Type: Article Affiliation country: Jpm11080762