The frequency of serious bacterial infection in febrile infants less than 90 days infected with SARS-CoV-2 and other respiratory viral pathogens

Abstract

Background The primary aim of this study was to compare the groups, SARS-CoV-2-positive and -negative patients, in terms of the frequency of SBI. The SARS-CoV-2-positive group was compared with the other-RVPs-positive group as a secondary evaluation in terms of serious bacterial infection (SBI). Methods This retrospective multicenter cohort study was conducted at four university hospitals from March 2020 to December 2021. Patients under 90 days old, with a measured fever of ≥ 38 °C, who were tested for SARS-CoV-2 and had blood and urine cultures taken, were included in the study. The patient groups who tested positive and negative for SARS-CoV-2 were compared regarding clinical characteristics, laboratory data, and the frequency of serious bacterial infections. As a secondary analysis, among patients tested for other respiratory viruses, the SARS-CoV-2-positive group and other respiratory virus-positive groups were compared in terms of the frequency of SBI. Results A total of 208 patients met the inclusion criteria. Two distinct comparisons were conducted among the patients included in the study: the first between the SARS-CoV-2-positive and SARS-CoV-2-negative patient groups, and the second between the SARS-CoV-2-positive and other RVPs-positive patient groups. In the first comparison, fifty-five patients were SARS-CoV-2-positive and 153 were SARS-CoV-2-negative. The rate of SBI in the SARS-CoV-2-positive patients was 16.4%, whereas that in the SARS-CoV-2-negative patients was 47.1%. The laboratory parameters for infection suspicion were significantly lower in the SARS-CoV-2-positive group than the SARS-CoV-2-negative group. In the second comparison, 90 patients who were tested for both SARS-CoV-2 and other RVPs were evaluated. The mean WBC, ANC and CRP levels were significantly lower in the SARS-CoV-2-positive group than the other RVPs-positive group, however, there was no significant difference in the mean ALC, NLR and PCT levels and the frequency of SBI between the SARS-CoV-2-positive and other RVPs-positive patient groups. Conclusions These results suggest that febrile infants younger than 90 days with SARS-CoV-2 have lower rates of SBI than patients without SARS-CoV-2. These data are consistent with previous studies describing lower risks of SBI in febrile infants with RVPs. Trial registration Not applicable.