Clinical characteristics of COVID-19 patients with clinically diagnosed bacterial co-infection: A multi-center study

Abstract

Objective To understand the clinical characteristics of COVID-19 patients with clinically diagnosed bacterial co-infection (CDBC), and therefore contributing to their early identification and prognosis estimation. Method 905 COVID-19 patients from 7 different centers were enrolled. The demography data, clinical manifestations, laboratory results, and treatments were collected accordingly for further analyses. Results Around 9.5% of the enrolled COVID-19 patients were diagnosed with CDBC. Older patients or patients with cardiovascular comorbidities have increased CDBC probability. Increased body temperature, longer fever duration, anhelation, gastrointestinal symptoms, illness severity, intensive care unit attending, ventilation treatment, glucocorticoid therapy, longer hospitalization time are correlated to CDBC. Among laboratory results, increased white blood cell counting (mainly neutrophil), lymphocytopenia, increased procalcitonin, erythrocyte sedimentation rate, C-reaction protein, D-dimer, blood urea nitrogen, lactate dehydrogenase, brain natriuretic peptide, myoglobin, blood sugar and decreased albumin are also observed, indicating multiple system functional damage. Radiology results suggested ground glass opacity mixed with high density effusion opacities and even pleural effusion. Conclusion The aged COVID-19 patients with increased inflammatory indicators, worse lymphopenia and cardiovascular comorbidities are more likely to have clinically diagnosed bacterial co-infection. Moreover, they tend to have severer clinical manifestations and increased probability of multiple system functional damage.

Antibiotic Prescriptions Targeting Bacterial Respiratory Infections in Admitted Patients with COVID-19: A Prospective Observational Study

“…Patients with a history of cerebrovascular disease are known to be at risk for aspiration pneumonia due to micro-aspiration, impaired airway clearance, insufficient tooth hygiene, relative immobilization and ineffective expectoration due to muscle weakness. In a study by He et al patients with cardiovascular comorbidities had a higher probability of a bRTI [43]. However, evaluation of the medical history and physical examination in patients with a history of cerebrovascular disease often contribute poorly to the COVID-19 or bRTI diagnosis, which can also explain the lower threshold to start antibiotics [44][45][46][47][48].…”

The use of antibiotics in COVID-19 management: a rapid review of national treatment guidelines in 10 African countries

“…Another meta-analysis revealed that only 7.0% of hospitalized COVID-19 patients had a bacterial co-infection [ 15 ]. A recent multi-center study showed that only 86 out of 905 (9.5%) confirmed COVID-19 patients were clinically diagnosed with bacterial co-infection [ 16 ]. This implies that only a few COVID-19 patients would need antibiotics for possible bacterial pneumonia and other superimposed/co-infections [ 17 ].…”

Antibiotic Use and Fatal Outcomes among Critically Ill Patients with COVID-19 in Tacna, Peru

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