COVID-19 and <i>Clostridioides difficile</i> Coinfection Outcomes among Hospitalized Patients in the United States: An Insight from National Inpatient Database
The incidence of <i>Clostridioides difficile</i> infection (CDI) has been increasing compared to pre-COVID-19 pandemic levels. The COVID-19 infection and CDI relationship can be affected by gut dysbiosis and poor antibiotic stewardship. As the COVID-19 pandemic transitions into an endemi...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-05-01
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| Series: | Infectious Disease Reports |
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| Online Access: | https://www.mdpi.com/2036-7449/15/3/28 |
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| author | Rehmat Ullah Awan Karthik Gangu Anthony Nguyen Prabal Chourasia Oscar F. Borja Montes Muhammad Ali Butt Taimur Sohail Muzammil Rao Mujtaba Afzal Ambreen Nabeel Rahul Shekhar Abu Baker Sheikh |
| author_facet | Rehmat Ullah Awan Karthik Gangu Anthony Nguyen Prabal Chourasia Oscar F. Borja Montes Muhammad Ali Butt Taimur Sohail Muzammil Rao Mujtaba Afzal Ambreen Nabeel Rahul Shekhar Abu Baker Sheikh |
| author_sort | Rehmat Ullah Awan |
| collection | DOAJ |
| description | The incidence of <i>Clostridioides difficile</i> infection (CDI) has been increasing compared to pre-COVID-19 pandemic levels. The COVID-19 infection and CDI relationship can be affected by gut dysbiosis and poor antibiotic stewardship. As the COVID-19 pandemic transitions into an endemic stage, it has become increasingly important to further characterize how concurrent infection with both conditions can impact patient outcomes. We performed a retrospective cohort study utilizing the 2020 NIS Healthcare Cost Utilization Project (HCUP) database with a total of 1,659,040 patients, with 10,710 (0.6%) of those patients with concurrent CDI. We found that patients with concurrent COVID-19 and CDI had worse outcomes compared to patients without CDI including higher in-hospital mortality (23% vs. 13.4%, aOR: 1.3, 95% CI: 1.12–1.5, <i>p</i> = 0.01), rates of in-hospital complications such as ileus (2.7% vs. 0.8%, <i>p</i> < 0.001), septic shock (21.0% vs. 7.2%, aOR: 2.3, 95% CI: 2.1–2.6, <i>p</i> < 0.001), length of stay (15.1 days vs. 8 days, <i>p</i> < 0.001) and overall cost of hospitalization (USD 196,012 vs. USD 91,162, <i>p</i> < 0.001). Patients with concurrent COVID-19 and CDI had increased morbidity and mortality, and added significant preventable burden on the healthcare system. Optimizing hand hygiene and antibiotic stewardship during in-hospital admissions can help to reduce worse outcomes in this population, and more efforts should be directly made to reduce CDI in hospitalized patients with COVID-19 infection. |
| first_indexed | 2024-03-11T02:22:45Z |
| format | Article |
| id | doaj.art-ad796d0d9fa3452ebe811519b9d97f0c |
| institution | Directory Open Access Journal |
| issn | 2036-7449 |
| language | English |
| last_indexed | 2024-03-11T02:22:45Z |
| publishDate | 2023-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Infectious Disease Reports |
| spelling | doaj.art-ad796d0d9fa3452ebe811519b9d97f0c2023-11-18T10:42:56ZengMDPI AGInfectious Disease Reports2036-74492023-05-0115327929110.3390/idr15030028COVID-19 and <i>Clostridioides difficile</i> Coinfection Outcomes among Hospitalized Patients in the United States: An Insight from National Inpatient DatabaseRehmat Ullah Awan0Karthik Gangu1Anthony Nguyen2Prabal Chourasia3Oscar F. Borja Montes4Muhammad Ali Butt5Taimur Sohail Muzammil6Rao Mujtaba Afzal7Ambreen Nabeel8Rahul Shekhar9Abu Baker Sheikh10Department of Internal Medicine, Ochsner Rush Medical Center, Meridian, MS 39301, USADepartment of Internal Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USADivision of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM 87106, USADepartment of Hospital Medicine, Mary Washington Hospital, Fredericksburg, VA 22401, USADivision of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM 87106, USADepartment of Internal Medicine, Allegheny Health Network, Pittsburgh, PA 15212, USADepartment of Internal Medicine, Allegheny Health Network, Pittsburgh, PA 15212, USADepartment of Internal Medicine, University of Pittsburg Medical Center, Pittsburgh, PA 15213, USADepartment of Internal Medicine, Ochsner Rush Medical Center, Meridian, MS 39301, USADivision of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM 87106, USADivision of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM 87106, USAThe incidence of <i>Clostridioides difficile</i> infection (CDI) has been increasing compared to pre-COVID-19 pandemic levels. The COVID-19 infection and CDI relationship can be affected by gut dysbiosis and poor antibiotic stewardship. As the COVID-19 pandemic transitions into an endemic stage, it has become increasingly important to further characterize how concurrent infection with both conditions can impact patient outcomes. We performed a retrospective cohort study utilizing the 2020 NIS Healthcare Cost Utilization Project (HCUP) database with a total of 1,659,040 patients, with 10,710 (0.6%) of those patients with concurrent CDI. We found that patients with concurrent COVID-19 and CDI had worse outcomes compared to patients without CDI including higher in-hospital mortality (23% vs. 13.4%, aOR: 1.3, 95% CI: 1.12–1.5, <i>p</i> = 0.01), rates of in-hospital complications such as ileus (2.7% vs. 0.8%, <i>p</i> < 0.001), septic shock (21.0% vs. 7.2%, aOR: 2.3, 95% CI: 2.1–2.6, <i>p</i> < 0.001), length of stay (15.1 days vs. 8 days, <i>p</i> < 0.001) and overall cost of hospitalization (USD 196,012 vs. USD 91,162, <i>p</i> < 0.001). Patients with concurrent COVID-19 and CDI had increased morbidity and mortality, and added significant preventable burden on the healthcare system. Optimizing hand hygiene and antibiotic stewardship during in-hospital admissions can help to reduce worse outcomes in this population, and more efforts should be directly made to reduce CDI in hospitalized patients with COVID-19 infection.https://www.mdpi.com/2036-7449/15/3/28COVID-19complicationsmortalitynational inpatient sample<i>Clostridioides difficile</i> |
| spellingShingle | Rehmat Ullah Awan Karthik Gangu Anthony Nguyen Prabal Chourasia Oscar F. Borja Montes Muhammad Ali Butt Taimur Sohail Muzammil Rao Mujtaba Afzal Ambreen Nabeel Rahul Shekhar Abu Baker Sheikh COVID-19 and <i>Clostridioides difficile</i> Coinfection Outcomes among Hospitalized Patients in the United States: An Insight from National Inpatient Database Infectious Disease Reports COVID-19 complications mortality national inpatient sample <i>Clostridioides difficile</i> |
| title | COVID-19 and <i>Clostridioides difficile</i> Coinfection Outcomes among Hospitalized Patients in the United States: An Insight from National Inpatient Database |
| title_full | COVID-19 and <i>Clostridioides difficile</i> Coinfection Outcomes among Hospitalized Patients in the United States: An Insight from National Inpatient Database |
| title_fullStr | COVID-19 and <i>Clostridioides difficile</i> Coinfection Outcomes among Hospitalized Patients in the United States: An Insight from National Inpatient Database |
| title_full_unstemmed | COVID-19 and <i>Clostridioides difficile</i> Coinfection Outcomes among Hospitalized Patients in the United States: An Insight from National Inpatient Database |
| title_short | COVID-19 and <i>Clostridioides difficile</i> Coinfection Outcomes among Hospitalized Patients in the United States: An Insight from National Inpatient Database |
| title_sort | covid 19 and i clostridioides difficile i coinfection outcomes among hospitalized patients in the united states an insight from national inpatient database |
| topic | COVID-19 complications mortality national inpatient sample <i>Clostridioides difficile</i> |
| url | https://www.mdpi.com/2036-7449/15/3/28 |
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