Bacterial co-infection raises in-hospital mortality of COVID-19 patients: a retrospective study
BackgroundWe aim to explore whether the bacterial co-infection with COVID-19 will raise the in-hospital mortality.MethodsCOVID-19 patients’ information were collected for analysis in our retrospective study. Neutrophil count and procalcitonin (PCT) were used to estimate whether there was a suspected...
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Frontiers Media S.A.
2023-06-01
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Online Access: | https://www.frontiersin.org/articles/10.3389/fmicb.2023.1206476/full |
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author | Kaican Zong Wen Li Yingya Fu Sha Zhang Yi Liu Shiying Li |
author_facet | Kaican Zong Wen Li Yingya Fu Sha Zhang Yi Liu Shiying Li |
author_sort | Kaican Zong |
collection | DOAJ |
description | BackgroundWe aim to explore whether the bacterial co-infection with COVID-19 will raise the in-hospital mortality.MethodsCOVID-19 patients’ information were collected for analysis in our retrospective study. Neutrophil count and procalcitonin (PCT) were used to estimate whether there was a suspected bacterial co-infection.ResultsThe main baselines between the suspected bacterial infection (SBI) and no evidence of bacterial infection (NBI) groups were no significant differences. In SBI group, patients required more therapies than NBI group. There was significantly higher in-hospital mortality (26% vs.9%, P < 0.001) between SBI and NBI groups in overall population. And in each subgroup based on pneumonia inflammation index (PII), it also showed higher in-hospital mortality of COVID-19 patients with bacterial co-infection. With logistic regression models, it showed that bacterial co-infection was associated with significantly higher in-hospital mortality in overall population (OR 1.694, 95% CI 1.179–2.434, p = 0.004) and mild subgroup (OR 2.374, 95% CI 1.249–4.514, p = 0.008). The rate of bacterial co-infection in overall population was 51%. At the same time, it showed a significantly higher rate of bacterial co-infection in critical subgroup than severe subgroup (63% vs. 49%, p = 0.003), and than that in moderate subgroup (63% vs. 48%, p = 0.002) based on clinical classification. It showed a significantly higher rates of bacterial co-infection in severe subgroup than moderate subgroup (66% vs. 49%, p = 0.001) based on PII. The result showed that the risk factor associated with significantly higher in-hospital mortality was PII (OR 1.018, 95%CI 1.012 to 1.024, P < 0.001) with logistic regression models.InterpretationBacterial co-infection estimated by Neutrophil count and procalcitonin significantly raises in-hospital mortality of COVID-19 patients in overall population in our study. Its impact is more significant in mild and moderate PII subgroups. PII based on CT imaging combined with neutrophil count and PCT is beneficial for accurate differentiation of bacterial co-infection of COVID-19. |
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spelling | doaj.art-d7aeebbd251a47de988db19a4e4c62e72023-06-30T09:35:57ZengFrontiers Media S.A.Frontiers in Microbiology1664-302X2023-06-011410.3389/fmicb.2023.12064761206476Bacterial co-infection raises in-hospital mortality of COVID-19 patients: a retrospective studyKaican Zong0Wen Li1Yingya Fu2Sha Zhang3Yi Liu4Shiying Li5Department of Respiratory Medicine, The Seventh People’s Hospital of Chongqing, Affiliated Central Hospital of Chongqing University of Technology, Chongqing, ChinaDepartment of Respiratory Medicine, The Seventh People’s Hospital of Chongqing, Affiliated Central Hospital of Chongqing University of Technology, Chongqing, ChinaDepartment of Respiratory Medicine, The Seventh People’s Hospital of Chongqing, Affiliated Central Hospital of Chongqing University of Technology, Chongqing, ChinaDepartment of Respiratory Medicine, The Seventh People’s Hospital of Chongqing, Affiliated Central Hospital of Chongqing University of Technology, Chongqing, ChinaDepartment of Infectious Diseases, Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, ChinaDepartment of Infectious Diseases, Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, ChinaBackgroundWe aim to explore whether the bacterial co-infection with COVID-19 will raise the in-hospital mortality.MethodsCOVID-19 patients’ information were collected for analysis in our retrospective study. Neutrophil count and procalcitonin (PCT) were used to estimate whether there was a suspected bacterial co-infection.ResultsThe main baselines between the suspected bacterial infection (SBI) and no evidence of bacterial infection (NBI) groups were no significant differences. In SBI group, patients required more therapies than NBI group. There was significantly higher in-hospital mortality (26% vs.9%, P < 0.001) between SBI and NBI groups in overall population. And in each subgroup based on pneumonia inflammation index (PII), it also showed higher in-hospital mortality of COVID-19 patients with bacterial co-infection. With logistic regression models, it showed that bacterial co-infection was associated with significantly higher in-hospital mortality in overall population (OR 1.694, 95% CI 1.179–2.434, p = 0.004) and mild subgroup (OR 2.374, 95% CI 1.249–4.514, p = 0.008). The rate of bacterial co-infection in overall population was 51%. At the same time, it showed a significantly higher rate of bacterial co-infection in critical subgroup than severe subgroup (63% vs. 49%, p = 0.003), and than that in moderate subgroup (63% vs. 48%, p = 0.002) based on clinical classification. It showed a significantly higher rates of bacterial co-infection in severe subgroup than moderate subgroup (66% vs. 49%, p = 0.001) based on PII. The result showed that the risk factor associated with significantly higher in-hospital mortality was PII (OR 1.018, 95%CI 1.012 to 1.024, P < 0.001) with logistic regression models.InterpretationBacterial co-infection estimated by Neutrophil count and procalcitonin significantly raises in-hospital mortality of COVID-19 patients in overall population in our study. Its impact is more significant in mild and moderate PII subgroups. PII based on CT imaging combined with neutrophil count and PCT is beneficial for accurate differentiation of bacterial co-infection of COVID-19.https://www.frontiersin.org/articles/10.3389/fmicb.2023.1206476/fullbacterial co-infectionCOVID-19pneumoniamortalityrisk factor |
spellingShingle | Kaican Zong Wen Li Yingya Fu Sha Zhang Yi Liu Shiying Li Bacterial co-infection raises in-hospital mortality of COVID-19 patients: a retrospective study Frontiers in Microbiology bacterial co-infection COVID-19 pneumonia mortality risk factor |
title | Bacterial co-infection raises in-hospital mortality of COVID-19 patients: a retrospective study |
title_full | Bacterial co-infection raises in-hospital mortality of COVID-19 patients: a retrospective study |
title_fullStr | Bacterial co-infection raises in-hospital mortality of COVID-19 patients: a retrospective study |
title_full_unstemmed | Bacterial co-infection raises in-hospital mortality of COVID-19 patients: a retrospective study |
title_short | Bacterial co-infection raises in-hospital mortality of COVID-19 patients: a retrospective study |
title_sort | bacterial co infection raises in hospital mortality of covid 19 patients a retrospective study |
topic | bacterial co-infection COVID-19 pneumonia mortality risk factor |
url | https://www.frontiersin.org/articles/10.3389/fmicb.2023.1206476/full |
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