Secondary Bloodstream Infections Tied to Poorer COVID-19 Outcomes
Altered mental status, ICU admission, higher in-hospital mortality more likely in hospitalized patients with severe COVID-19 and sBSI
WEDNESDAY, Dec. 30, 2020 (HealthDay News) -- Hospitalized adult patients with severe COVID-19 and secondary bloodstream infections (sBSIs) are more likely to have worse clinical outcomes, including higher in-hospital mortality, according to a study recently published in Clinical Infectious Diseases.
Pinki J. Bhatt, M.D., from the Rutgers Robert Wood Johnson Medical School in New Brunswick, New Jersey, and colleagues conducted a case-control study involving all hospitalized patients with severe COVID-19 and blood cultures drawn from March 1 to May 7, 2020. Risk factors and outcomes were compared between cases with sBSIs and controls (no sBSIs) among 375 hospitalized patients.
The researchers identified 128 sBSI cases during hospitalization. For the first set of positive blood cultures, 91.4 and 5.5 percent were bacterial and fungal, respectively. Compared with controls, those with sBSIs were more likely to have altered mental status, lower mean percentage oxygen saturation on room air, and septic shock and were more likely to be admitted to the intensive care unit. Compared with controls, cases with sBSIs had significantly higher in-hospital mortality (53.1 versus 32.8 percent).
"Hospitalized adult patients with severe COVID-19 with sBSIs had a more severe initial presentation, prolonged hospital course, and worse clinical outcomes," the authors write. "To maintain antimicrobial stewardship principles, further prospective studies are necessary to better characterize risk factors and prediction modeling to better understand when to suspect and empirically treat for sBSIs in severe COVID-19."
Several authors disclosed financial ties to the pharmaceutical industry.