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Incidence of bloodstream infections in patients with COVID-19: a retrospective cohort study of risk factors and outcomes.
Santos, Claudia Villatoro; Fukushima, Elisa Akagi; Zhao, Wei; Sharma, Mamta; Youssef, Dima; Spzunar, Susan; Levine, Miriam; Saravolatz, Louis; Bhargava, Ashish.
  • Santos CV; MD, PhD, Internal Medicine Department. Ascension St John Hospital, Detroit, MI. 48236, USA.
  • Fukushima EA; MD, Infectious Disease Department. Ascension St John Hospital, Detroit, MI. 48236, USA.
  • Zhao W; MD, PhD, Infectious Disease Department. Ascension St John Hospital, Detroit, MI. 48236, USA.
  • Sharma M; MD, FACP, FIDSA, Infectious Disease Department. Ascension St John Hospital, Detroit, MI. 48236, USA.
  • Youssef D; MD, Infectious Disease Department. Ascension St John Hospital, Detroit, MI. 48236, USA.
  • Spzunar S; MPH, PhD, Research Department. Ascension St John Hospital, Detroit, MI. 48236, USA.
  • Levine M; MD, FACP, Infectious Disease Department. Ascension St John Hospital, Detroit, MI. 48236, USA.
  • Saravolatz L; MD, MACP, FIDSA, Internal Medicine and Infectious Disease Department. Ascension St John Hospital, Detroit, MI. 48236, USA.
  • Bhargava A; MD, FACP, Infectious Disease Department. Ascension St John Hospital, Detroit, MI. 48236, USA.
Germs ; 12(2): 253-261, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-2033512
ABSTRACT

Introduction:

Prior evidence found that bloodstream infections (BSIs) are common in viral respiratory infections and can lead to heightened morbidity and mortality. We described the incidence, risk factors, and outcomes of BSIs in patients with COVID-19.

Methods:

This was a single-center retrospective cohort study of adults consecutively admitted from March to June 2020 for COVID-19 with BSIs. Data were collected by electronic medical record review. BSIs were defined as positive blood cultures (BCs) with a known pathogen in one or more BCs or the same commensal organism in two or more BCs.

Results:

We evaluated 290 patients with BCs done; 39 (13.4%) had a positive result. In univariable analysis, male sex, black/African American race, admission from a facility, hemiplegia, altered mental status, and a higher Charlson Comorbidity Index were positively associated with positive BCs, whereas obesity and systolic blood pressure (SBP) were negatively associated. Patients with positive BCs were more likely to have severe COVID-19, be admitted to the intensive care unit (ICU), require mechanical ventilation, have septic shock, and higher mortality. In multivariable logistic regression, factors that were independent predictors of positive BCs were male sex (OR=2.8, p=0.030), hypoalbuminemia (OR=3.3, p=0.013), ICU admission (OR=5.3, p<0.001), SBP<100 mmHg (OR=3.7, p=0.021) and having a procedure (OR=10.5, p=0.019). Patients with an abnormal chest X-ray on admission were less likely to have positive BCs (OR=0.3, p=0.007).

Conclusions:

We found that male sex, abnormal chest X-ray, low SBP, and hypoalbuminemia upon hospital admission, admission to ICU, and having a procedure during hospitalization were independent predictors of BSIs in patients with COVID-19.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Language: English Journal: Germs Year: 2022 Document Type: Article Affiliation country: Germs.2022.1327

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Language: English Journal: Germs Year: 2022 Document Type: Article Affiliation country: Germs.2022.1327