Exploring risk factors and antimicrobial resistance in co-infections among hospitalized COVID-19 patients: a 2020-2021 analysis

  1. Rescalvo-Casas, Carlos 27
  2. Fernández-Villegas, Rocío 2
  3. Hernando-Gozalo, Marcos 123
  4. Seijas-Pereda, Laura 26
  5. Lledó-García, Lourdes 27
  6. Cuadros-González, Juan 245
  7. Pérez-Tanoira, Ramón 27
  1. 1 Hospital Universitario Príncipe de Asturias
    info
    Hospital Universitario Príncipe de Asturias

    Alcalá de Henares, España

    ROR https://ror.org/01az6dv73

    Geographic location of the organization Hospital Universitario Príncipe de Asturias
  2. 2 Universidad de Alcalá
    info
    Universidad de Alcalá

    Alcalá de Henares, España

    ROR https://ror.org/04pmn0e78

    Geographic location of the organization Universidad de Alcalá
  3. 3 Dpto. Química Orgánica y Química Inorgánica
  4. 4 Hospital Universitario Príncipe de Asturias (Alcalá de Henares)
  5. 5 Servicio de Microbiología y Parasitología Clínica
  6. 6 Dpto. Biología de Sistemas
  7. 7 Dpto. Biomedicina y Biotecnología
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Journal:
Authorea

Year of publication: 2024

Type: Short Survey

DOI: 10.22541/AU.172994411.14732765/V1 GOOGLE SCHOLAR lock_openOpen access editor

Abstract

BackgroundCo-infections in COVID-19 patients can worsen disease severity by enhancing SARS-CoV-2 replication and pro-inflammatory cytokine levels. This study analyzes the characteristics of co-infected COVID-19 patients across the pandemic and their association with in-hospital mortality. MethodsWe retrospectively examined data from 351 COVID-19 patients hospitalized in a Spanish secondary Hospital between March 2020 and February-March 2021. Nasopharyngeal swabs from 340 patients were analyzed using multiplex RT-PCR to identify 26 respiratory pathogens.Results136 patients were co-infected with 191 bacteria (100 gram-negative, 91 gram-positive), 20 viruses, 18 fungi, and one protist. In 2021, empirical cephalosporin use increased (p=0.009). The incidence of enterococcal co-infections tripled from 2020 to 2021(p<0.001). In 2021, a greater proportion experienced urine(p=0.001) and bloodstream(p=0.010) co-infections. In 2020, there was one bloodstream infection, while in 2021 there were seven, half of them fatal.Co-infected patients experienced longer hospital stays and higher odds of long-COVID (p<0.001; p=0.014; p=0.045). Non-respiratory co-infections in 2021 correlated with increased mortality (p=0.002). Antimicrobial resistance remained stable (p=0.149).ConclusionsRise in cephalosporin use correlated with increased Enterococcus infections, notably bloodstream infections, linked to mortality (p=0.016). Nearly 70% of deceased patients in 2021 had co-infections which were associated with extended hospital stays and higher mortality risk. (Resumen completo publicado en: Authorea. October 26, 2024).