The DOI matches its Crossref record; 25 of the 25 references it cites were found in a registry or an index.
Secondary infections in patients hospitalized with COVID-19: incidence and predictive factors
Open accessAbstract
Objectives The aim of our study was to describe the incidence and predictive factors of secondary infections in patients with coronavirus disease 2019 (COVID-19). Methods This was a cohort study of patients hospitalized with COVID-19 at IRCCS San Raffaele Hospital between 25th February and 6th April 2020 (NCT04318366). We considered secondary bloodstream infections (BSIs) or possible lower respiratory tract infections (pLRTIs) occurring 48 hours after hospital admission until death or discharge. We calculated multivariable Fine–Gray models to assess factors associated with risk of secondary infections. Results Among 731 patients, a secondary infection was diagnosed in 68 patients (9.3%); 58/731 patients (7.9%) had at least one BSI and 22/731 patients (3.0%) at least one pLRTI. The overall 28-day cumulative incidence was 16.4% (95%CI 12.4–21.0%). Most of the BSIs were due to Gram-positive pathogens (76/106 isolates, 71.7%), specifically coagulase-negative staphylococci (53/76, 69.7%), while among Gram-negatives (23/106, 21.7%) Acinetobacter baumanii (7/23, 30.4%) and Escherichia coli (5/23, 21.7%) predominated. pLRTIs were caused mainly by Gram-negative pathogens (14/26, 53.8%). Eleven patients were diagnosed with putative invasive aspergillosis. At multivariable analysis, factors associated with secondary infections were low baseline lymphocyte count (≤0.7 versus >0.7 per 109/L, subdistribution hazard ratios (sdHRs) 1.93, 95%CI 1.11–3.35), baseline PaO2/FiO2 (per 100 points lower: sdHRs 1.56, 95%CI 1.21–2.04), and intensive-care unit (ICU) admission in the first 48 hours (sdHR 2.51, 95%CI 1.04–6.05). Conclusions Patients hospitalized with COVID-19 had a high incidence of secondary infections. At multivariable analysis, early need for ICU, respiratory failure, and severe lymphopenia were identified as risk factors for secondary infections.
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“We subsequently performed inverse probability-weighted (IPW) competing risks multivariable analyses to simultaneously account for indication bias associated with the treatment with biological immunosuppressive drugs and competing death for the estimation of the cumulative incidence of patients with secondary infection…”
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COVID-19: consider cytokine storm syndromes and immunosuppression
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Acinetobacter baumannii Antibiotic Resistance Mechanisms
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Multicenter Epidemiologic Study of Coronavirus Disease-Associated Mucormycosis, India
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“Health care-associated infections (HAI), also known as nosocomial infections, are acquired by patients while receiving care in hospitals and represent one of the most frequent adverse events affecting patient safety worldwide [2].”
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Metadata
- Authors
- Ripa, M., Galli, L., Poli, A., Oltolini, C., Spagnuolo, V., Mastrangelo, A., Muccini, C., Monti, G., De Luca, G., Landoni, G., Dagna, L., Clementi, M., Rovere Querini, P., Ciceri, F., Tresoldi, M., Lazzarin, A., Zangrillo, A., Scarpellini, P., Castagna, A., Andolina, A., Redaelli, M. B., Bigai, G., Bigoloni, A., Borio, G., Bossolasco, S., Bruzzesi, E., Calabrò, M. G., Calvisi, S., Campochiaro, C., Canetti, D., Canti, V., Castellani, J., Castiglioni, B., Cavalli, G., Cavallo, L., Cernuschi, M., Chiurlo, M., Cilla, M., Cinel, E., Cinque, P., Conte, C., Da Prat, V., Danise, A., De Lorenzo, R., Dell’Acqua, A., Dell’Acqua, R., Della Torre, E., Della Torre, L., Di Terlizzi, G., Dumea, I., Farolfi, F., Ferrante, M., Frangi, C., Fumagalli, L., Gallina, G., Germinario, B., Gianotti, N., Guffanti, M., Hasson, H., Lalla, F., Lanzillotta, M., Li Voti, R., Messina, E., Molinari, C., Moizo, E., Montagna, M., Morsica, G., Nozza, S., Pascali, M., Patrizi, A., Pieri, M., Poloniato, A., Prestifilippo, D., Ramirez, G., Ranzenigo, M., Sapienza, J., Seghi, F., Tambussi, G., Tassan Din, C., Turi, S., Uberti-Foppa, C., & Vinci, C.
- Venue
- Clinical Microbiology and Infection
- Publisher
- Elsevier BV
- Published
- 2021-03
- Volume
- 27
- Issue
- 3
- Pages
- 451-457
- ISSN
- 1198-743X (ISSN-L)
- OpenAlex
- W3093693178
- Cited by
- 363
- References
- 25
- FWCI
- 8.48
- Type
- journal article
- Language
- en
- Open access
- bronze
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- Ripa, M., Galli, L., Poli, A., Oltolini, C., Spagnuolo, V., Mastrangelo, A., Muccini, C., Monti, G., De Luca, G., Landoni, G., Dagna, L., Clementi, M., Rovere Querini, P., Ciceri, F., Tresoldi, M., Lazzarin, A., Zangrillo, A., Scarpellini, P., Castagna, A., . . . Vinci, C. (2021). Secondary infections in patients hospitalized with COVID-19: incidence and predictive factors. Clinical Microbiology and Infection. https://doi.org/10.1016/j.cmi.2020.10.021
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