Risk Factors of Secondary Infections in Severe and Critical Patients Hospitalized with COVID-19: A Case-Control Study

Abstract

Background: Severe patients hospitalized with COVID-19 suffered secondary infections which greatly increased the length of hospital stay and the mortality. We aimed to explore risk factors of secondary infections that can help clinicians early implement preventive measures to dispose of severe and critical inpatients with COVID-19.Methods: A case-control study enrolled 238 severe and critical patients with COVID-19. Characteristics of cases and controls were compared.Results: Severity of illness on admission, ICU admission, ventilator, central venous catheterization were common in the cases, however almost none of these factors was observed in the controls. Multivariable regression showed risk factors of secondary infections included male (OR 4.08; 95% CI 1.58-10.50), age 65 or older (OR 3.11; 95% CI 1.25-7.76), heart diseases (OR 3.96; 95% CI 1.40-11.27), hypoproteinemia on admission (OR 6.41; 95% CI 1.65-24.92) and corticosteroids (OR 19.83; 95% CI 7.3-53.55) and proton-pump inhibitors (OR 3.96; 95% CI 1.51-10.37).Conclusions: male, older age, heart diseases, hypoproteinemia, corticosteroid and proton-pump inhibitors were independent risk factors of secondary infections. Inpatients needing ICU admission and invasive devices still need to be given optimal cares and to be minimized the duration.

Development of an index predicts the in-patient mortality of COVID-19 patients presenting at a hospital in rural Michigan.

“…[44] Additionally, those with low levels of protein were more likely to go on to develop a second infection, thus implying that low protein levels might indicate a compromised immune system. [45] Albumin is a common protein measured in the body and decreased levels are seen in liver disease. Our study has identi ed key historical and objective measurements that were demonstrated to be predictive of increased inpatient mortality in those hospitalized with COVID-19.…”

Will Proton Pump Inhibitors Lead to a Higher Risk of COVID-19 Infection and Progression to Severe Disease? A Meta-analysis

“…Two articles [12,17] investigating PPI use and risk of secondary infection were found in the database, we combined them and found that PPI use was associated with increased risk of secondary infection. (OR=4.33, 95% CI=2.57-7.29, P<0.001; I 2 =0%, P heterogeneity =0.570) ( Figure 5 ).…”

“…Analysis of seven studies [9][10][11][12][13][14][15] on risk of COVID-19 infection found that the use of PPI was not associated with increased or decreased risk of COVID-19 infection (OR:1.64, 95%CI = 0.54-5.00, P=0.390; I 2 =100%, P heterogeneity <0.001). (Figure 2 The result of nine studies from eight original articles [7,9,[16][17][18][19][20][21] showed that PPI use was associated with increased risk of severe disease, including admission to ICU,…”

Does Proton Pump Inhibitor Use Lead to a Higher Risk of Coronavirus Disease 2019 Infection and Progression to Severe Disease? a Meta-analysis

“…Two articles (12,17) investigating PPI use and risk of secondary infection were found in the database, we combined them and found that PPI use was associated with an increased risk of secondary infection. (OR=4.33, 95% CI=2.57-7.29, P<0.001; I 2 =0%, Pheterogeneity =0.570) (Figure 5).…”