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Bacterial co-infection and secondary infection in patients with COVID-19: a living rapid review and meta-analysis.
Langford, Bradley J; So, Miranda; Raybardhan, Sumit; Leung, Valerie; Westwood, Duncan; MacFadden, Derek R; Soucy, Jean-Paul R; Daneman, Nick.
  • Langford BJ; Public Health Ontario, ON, Canada; Hotel Dieu Shaver Health and Rehabilitation Centre, ON, Canada. Electronic address: brad.langford@gmail.com.
  • So M; Sinai Health-University Health Network Antimicrobial Stewardship Program, University Health Network, ON, Canada; University of Toronto, ON, Canada; Toronto General Hospital Research Institute, ON, Canada.
  • Raybardhan S; North York General Hospital, ON, Canada.
  • Leung V; Public Health Ontario, ON, Canada; Toronto East Health Network, Michael Garron Hospital, ON Canada.
  • Westwood D; Sunnybrook Research Institute, ON, Canada.
  • MacFadden DR; Ottawa Hospital Research Institute, ON, Canada.
  • Soucy JR; Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, ON, Canada.
  • Daneman N; Public Health Ontario, ON, Canada; University of Toronto, ON, Canada; Sunnybrook Research Institute, ON, Canada; ICES (formerly Institute for Clinical Evaluative Sciences), ON, Canada.
Clin Microbiol Infect ; 26(12): 1622-1629, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-664356
ABSTRACT

BACKGROUND:

Bacterial co-pathogens are commonly identified in viral respiratory infections and are important causes of morbidity and mortality. The prevalence of bacterial infection in patients infected with SARS-CoV-2 is not well understood.

AIMS:

To determine the prevalence of bacterial co-infection (at presentation) and secondary infection (after presentation) in patients with COVID-19. SOURCES We performed a systematic search of MEDLINE, OVID Epub and EMBASE databases for English language literature from 2019 to April 16, 2020. Studies were included if they (a) evaluated patients with confirmed COVID-19 and (b) reported the prevalence of acute bacterial infection. CONTENT Data were extracted by a single reviewer and cross-checked by a second reviewer. The main outcome was the proportion of COVID-19 patients with an acute bacterial infection. Any bacteria detected from non-respiratory-tract or non-bloodstream sources were excluded. Of 1308 studies screened, 24 were eligible and included in the rapid review representing 3338 patients with COVID-19 evaluated for acute bacterial infection. In the meta-analysis, bacterial co-infection (estimated on presentation) was identified in 3.5% of patients (95%CI 0.4-6.7%) and secondary bacterial infection in 14.3% of patients (95%CI 9.6-18.9%). The overall proportion of COVID-19 patients with bacterial infection was 6.9% (95%CI 4.3-9.5%). Bacterial infection was more common in critically ill patients (8.1%, 95%CI 2.3-13.8%). The majority of patients with COVID-19 received antibiotics (71.9%, 95%CI 56.1 to 87.7%). IMPLICATIONS Bacterial co-infection is relatively infrequent in hospitalized patients with COVID-19. The majority of these patients may not require empirical antibacterial treatment.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Bacterial Infections / Coinfection / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Topics: Long Covid Limits: Female / Humans / Male Country/Region as subject: North America / Asia Language: English Journal: Clin Microbiol Infect Journal subject: Communicable Diseases / Microbiology Year: 2020 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Bacterial Infections / Coinfection / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Topics: Long Covid Limits: Female / Humans / Male Country/Region as subject: North America / Asia Language: English Journal: Clin Microbiol Infect Journal subject: Communicable Diseases / Microbiology Year: 2020 Document Type: Article