Open Forum Infect Dis . Prevalence of Co-infection at the Time of Hospital Admission in COVID-19 Patients, A Multicenter Study

[tetano]

Open Forum Infect Dis


. 2020 Dec 21;8(1)faa578.
doi: 10.1093/ofid/ofaa578. eCollection 2021 Jan.
Prevalence of Co-infection at the Time of Hospital Admission in COVID-19 Patients, A Multicenter Study


Sara M Karaba[SUP] 1 [/SUP], George Jones[SUP] 1 [/SUP], Taylor Helsel[SUP] 2 [/SUP], L Leigh Smith[SUP] 1 [/SUP], Robin Avery[SUP] 1 [/SUP], Kathryn Dzintars[SUP] 3 4 [/SUP], Alejandra B Salinas[SUP] 1 [/SUP], Sara C Keller[SUP] 1 3 [/SUP], Jennifer L Townsend[SUP] 5 [/SUP], Eili Klein[SUP] 6 [/SUP], Joe Amoah[SUP] 7 [/SUP], Brian T Garibaldi[SUP] 8 [/SUP], Sara E Cosgrove[SUP] 1 3 [/SUP], Valeria Fabre[SUP] 1 3 [/SUP]



Affiliations

• PMID: 33447639
• PMCID: PMC7793465
• DOI: 10.1093/ofid/ofaa578

Abstract

Background: Bacterial infections may complicate viral pneumonias. Recent reports suggest that bacterial co-infection at time of presentation is uncommon in coronavirus disease 2019 (COVID-19); however, estimates were based on microbiology tests alone. We sought to develop and apply consensus definitions, incorporating clinical criteria to better understand the rate of co-infections and antibiotic use in COVID-19.
Methods: A total of 1016 adult patients admitted to 5 hospitals in the Johns Hopkins Health System between March 1, 2020, and May 31, 2020, with COVID-19 were evaluated. Adjudication of co-infection using definitions developed by a multidisciplinary team for this study was performed. Both respiratory and common nonrespiratory co-infections were assessed. The definition of bacterial community-acquired pneumonia (bCAP) included proven (clinical, laboratory, and radiographic criteria plus microbiologic diagnosis), probable (clinical, laboratory, and radiographic criteria without microbiologic diagnosis), and possible (not all clinical, laboratory, and radiographic criteria met) categories. Clinical characteristics and antimicrobial use were assessed in the context of the consensus definitions.
Results: Bacterial respiratory co-infections were infrequent (1.2%); 1 patient had proven bCAP, and 11 (1.1%) had probable bCAP. Two patients (0.2%) had viral respiratory co-infections. Although 69% of patients received antibiotics for pneumonia, the majority were stopped within 48 hours in patients with possible or no evidence of bCAP. The most common nonrespiratory infection was urinary tract infection (present in 3% of the cohort).
Conclusions: Using multidisciplinary consensus definitions, proven or probable bCAP was uncommon in adults hospitalized due to COVID-19, as were other nonrespiratory bacterial infections. Empiric antibiotic use was high, highlighting the need to enhance antibiotic stewardship in the treatment of viral pneumonias.

Keywords: COVID-19; SARS-CoV-2; antimicrobial use; co-infection; community-acquired pneumonia.

 

[kiwibird]

Thank you Tetano. Do you think pneumovax would help with severity?

 

[kiwibird]

https://theconversation.com/until-a...ccines-may-reduce-deaths-from-covid-19-147829

...
Could differences in the rates of vaccination against one or more diseases account for differences in COVID-19 risks? As someone who had previously investigated other pandemics such as the Great Flu Pandemic of 1918-19 and AIDS, and who has worked with vaccines, I had a strong background for tracking down the relevant data to test my hypothesis.
...
A recent preprint study (not yet peer-reviewed) from researchers at the Mayo Clinic has also reported very strong associations between pneumococcal vaccination and protection against COVID-19. This is especially true among minority patients who are bearing the brunt of the coronavirus pandemic. The report also suggests that other vaccines, or combinations of vaccines, such as Hib and MMR may also provide protection.
...snip

 

[kiwibird]

Posted for discussion and further research.