A meta-meta-analysis of co-infection, secondary infections, and antimicrobial resistance in COVID-19 patients

Suleiman, Adeiza Shuaibu; Islam, Aminul; Akter, Mir Salma; Amin, Mohammad Ruhul; Werkneh, Adhena Ayaliew; Bhattacharya, Prosun

doi:10.1016/j.jiph.2023.07.005

Cited by 19 publications

(8 citation statements)

References 22 publications

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“…(4.6%), Mucor spp. (1.3%), and Cryptococcus (0.5%), 56 , 58 we observed that the most frequently reported fungal infections in patients recovered from COVID-19 were Mucor spp. and P. jirovecii .…”

Section: Discussionmentioning

confidence: 74%

“…In general, fungal infections in patients recovered from COVID-19 are less frequent than in the acute phase of the disease. 56 The majority of fungal infections in these patients occurred in men over 45 years of age with a history of COVID-19 severe illness (pneumonia severe with respiratory rate >30 breaths/min, or severe respiratory distress, or SpO 2 <90% on room air), 57 causing a mortality of 14%. Unlike fungal co-infections in patients with acute COVID-19, where the majority of pathogens reported were Candida (7.1%), Aspergillus spp.…”

Section: Discussionmentioning

confidence: 98%

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Fungal infections in patients after recovering from COVID-19: a systematic review

Ulloque-Badaracco,

Copaja-Corzo,

Hernandez-Bustamante

et al. 2024

Therapeutic Advances in Infection

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Background and aims: The presence of fungal infections has been described in patients after recovering from COVID-19. This study aims to conduct a systematic review of studies that reported fungal infections ( Mucor spp., Pneumocystis jirovecii, or Aspergillus spp.) in adults after recovering from COVID-19. Methods: We performed a systematic review through PubMed, Web of Science, OVID-Medline, Embase, and Scopus. The study selection process was performed independently and by at least two authors. We performed a risk of bias assessment using the Newcastle–Ottawa Scale for cohort and case–control studies, and the Joanna Briggs Institute’s Checklists for Case Series and Case Reports. Results: The systematic search found 33 studies meeting all inclusion criteria. There was a total population of 774 participants, ranging from 21 to 87 years. From them, 746 developed a fungal infection. In 19 studies, Mucor spp. was reported as the main mycosis. In 10 studies, P. jirovecii was reported as the main mycosis. In seven studies, Aspergillus spp. was reported as the main mycosis. Regarding the quality assessment, 12 studies were classified as low risk of bias and the remaining studies as high risk of bias. Conclusion: Patients’ clinical presentation and prognosis after recovering from COVID-19 with fungal infection differ from those reported patients with acute COVID-19 infection and those without COVID-19 infection.

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Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 98%

Fungal infections in patients after recovering from COVID-19: a systematic review

Ulloque-Badaracco,

Copaja-Corzo,

Hernandez-Bustamante

et al. 2024

Therapeutic Advances in Infection

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“…In a recently published systematic review, they consider that there was no clear definition between co-infection and secondary infection; however, a percentage of up to 26% and 19% was found, respectively. 76 What there is greater consensus on is that they increase the mortality rate in COVID-19 patients. 77 Another recent study identified risk factors for bloodstream infections in COVID-19 patients, highlighting in its results the consumption of interleukin inhibitors (i.e.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 associated with cryptococcosis: a scoping review

Quincho-Lopez,

Poma,

José Montenegro-Idrogo

2024

Therapeutic Advances in Infection

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Background: There is growing evidence of fungal infections associated with COVID-19. The development of cryptococcosis in these patients has been infrequently reported. However, it can be life-threatening. Objective: To identify cases of COVID-19 patients who developed cryptococcosis and to compare baseline characteristics and management between those who survived and those who died. Methods: We conducted a scoping review using PubMed, Scopus, Web of Science, and Embase to identify studies that reported patients with COVID-19 and cryptococcosis. No language restriction was applied. Single case reports, case series, and original articles were included. It is important to note that ‘ n’ refers to the total number of individuals with the specified variable. Results: A total of 58 studies were included. Among these studies, 51 included individual patient data, detailing information on a total of 65 patients, whereas eight studies reported the proportion of cryptococcosis in COVID-19 patients. One study provided both individual and aggregate case information. From individual patient data, the majority were male (73.9%; n = 48) with a median age of 60 years (range: 53–70). Severe COVID-19 and multiple comorbidities, led by arterial hypertension and diabetes mellitus, were frequently reported, but few had classic immunosuppression factors. On the other hand, HIV status, either negative or positive, was reported in just over half of the patients (61.5%; n = 40). Most were admitted to the intensive care unit (ICU) (58.5%; n = 31), received mechanical ventilation (MV) (50.0%; n = 26), and developed disseminated cryptococcosis (55.4%; n = 36). Secondary infection, mainly bacterial, was reported in 19 patients (29.2%). Mortality was 47.7% ( n = 31). Of the studies that reported the proportion of cryptococcosis in COVID-19 cases, the majority were descriptive studies published as conference abstracts. Conclusion: Cryptococcosis in COVID-19 patients has been reported more frequently. However, it is still not as common as other fungal infections associated with COVID-19. Few patients have some classic immunosuppression factors. The factors associated with mortality were male sex, age, ICU admission, MV, secondary infections, and lymphopenia.

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“…As a meta-analysis, our conclusions derive from previously published articles, which in turn relied on observational data rather than originating from original research. This reliance on existing literature restricts our capacity for individual patient data analysis and exposes us to potential heterogeneity across studies, as well as the inherent risk of incorporating errors or biases inherent in the original studies 50 .…”

Section: Discussionmentioning

confidence: 99%

Impact of antibiotic-coated sutures on surgical site infections: a second-order meta-analysis

Suleiman,

Abbass,

Hossain

et al. 2023

International Journal of Surgery

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Background: Surgical site infections (SSIs) pose a global challenge, impacting patients and healthcare expenditures. This second-order meta-analysis endeavors to assess the efficacy of antibiotic sutures in averting SSIs by amalgamating data from various meta-studies. Materials and Methods This research adhered to the PRISMA 2020 guidelines. The quality and comprehensiveness of the encompassed meta-analyses were assessed through the QUOROM checklist and AMSTAR techniques. The primary study overlap was evaluated via measures such as pairwise intersection heat maps, Corrected Covered Area (CCA), and the citation matrix of evidence. The statistical power at the study level was determined utilizing the meta-meta package. Data synthesis employed random and fixed effects models at a 95% confidence interval. A meta-regression analysis was conducted to explore potential correlations between the CDC classification of surgical site infections, trial types, and the observed effect sizes in the studies. Results This investigation revealed a significant reduction in SSI rates due to antimicrobial-coated sutures, evidenced by a relative risk (RR) of 0.68 (95% CI: 0.59 to 0.76), with a prediction interval of 0.38 to 1.19. The analysis encompassed 18 studies with 22 meta-analyses, demonstrating a median QUOROM score of 13.6 out of 18 and an AMSTAR score of 9.1 out of 11. The presence of moderate heterogeneity was noted (Q=106.611, I square=54.038%), with non-randomized controlled trials (RCTs) exhibiting an RR of 0.56 (95% CI: 0.39 to 0.80), and RCTs displaying an RR of 0.71 (95% CI: 0.63 to 0.81). Subgroup analysis unveiled variable RR reductions for specific surgical procedures. Conclusion Antimicrobial-coated sutures offer a promising approach to mitigating surgical site infection risk (SSIs). However, their efficacy is optimally realized when employed in conjunction with other robust practices.

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A meta-meta-analysis of co-infection, secondary infections, and antimicrobial resistance in COVID-19 patients

Cited by 19 publications

References 22 publications

Fungal infections in patients after recovering from COVID-19: a systematic review

Fungal infections in patients after recovering from COVID-19: a systematic review

COVID-19 associated with cryptococcosis: a scoping review

Impact of antibiotic-coated sutures on surgical site infections: a second-order meta-analysis

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