Infectious Disease

Sufferers with COVID-19 and secondary bloodstream infections are usually sicker upon admission

December 09, 2020

2 min read

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Disclosure:
Bhatt reports that outside of this study, he received a Gilead research grant. In the study you will find all relevant financial information from all other authors.

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Adult patients hospitalized with severe COVID-19 and secondary bloodstream infections had a heavier initial presentation, longer hospital stay, and poorer clinical outcomes, according to a recent study.

“Anecdotally, when I was caring for or consulting with COVID-19 infected patients, we found that a large proportion of them were co-infected with secondary bloodstream infection (sBSI).” Pinki J. Bhatt, MD, Assistant Professor in the Infectious Diseases Division at Rutgers Robert Wood Johnson Medical School and Assistant Professor at Rutgers Ernest Mario School of Pharmacy, Healio said. “So this prompted us to see how common it was in three of our New Jersey hospitals, as well as investigate risk factors and outcomes in patients with COVID-19 and a simultaneous bloodstream infection.”

Pinki J. Bhatt

Bhatt and colleagues conducted a case-control study of all hospitalized patients diagnosed with severe COVID-19 with blood cultures between March 1 and May 7, 2020 at three academic medical centers in New Jersey. According to the study, risk factors and outcomes were compared between patients with sBSI and controls without sBSI.

A total of 375 hospitalized patients were included in the study. The researchers found that there were 128 sBSIs during the hospital stay. Among the first positive blood cultures, 117 (91.4%) were bacterial and seven (5.5%) were fungal. Researchers observed that adult patients with severe COVID-19 and sBSI in the hospital had a heavier initial visit, longer hospital stay (17 days versus 6.5 days; P <0.001), and poorer clinical outcomes. They also found that patients with sBSI were more likely to have altered mental status (15.7), lower mean indoor air oxygen saturation percentages (82.5% versus 86.1%), septic shock, and ICU admission (71.1% versus 35.6%); P <0.001) compared to controls. Additionally, the study showed that in-hospital mortality was higher in patients with an sBSI compared to controls (53.1% vs 32.8%; P = 0.0001).

‚ÄúPatients with COVID-19 and sBSI are certainly more ill than patients with COVID-19, but without sBSI, with a higher mortality in hospital. We found that all of our patients received antimicrobials at some point, regardless of whether they had an sBSI or not. We feel it is important to adhere to antimicrobial management principles at this unprecedented time. However, more prospective studies are needed to better characterize risk factors and predictive models and understand when sBSI should be suspected and empirically treated in severe COVID-19. “

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