Coinfection and superinfection in ICU critically ill patients with severe COVID-19 pneumonia and influenza pneumonia: are the pictures different?
BackgroundSimilar to influenza, coinfections and superinfections are common and might result in poor prognosis. Our study aimed to compare the characteristics and risks of coinfections and superinfections in severe COVID-19 and influenza virus pneumonia.MethodsThe data of patients with COVID-19 and...
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Frontiers Media S.A.
2023-08-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2023.1195048/full |
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| author | Ziying Chen Ziying Chen Ziying Chen Ziying Chen Ziying Chen Ziying Chen Qingyuan Zhan Qingyuan Zhan Qingyuan Zhan Qingyuan Zhan Qingyuan Zhan Qingyuan Zhan Linna Huang Linna Huang Linna Huang Linna Huang Linna Huang Chen Wang Chen Wang Chen Wang Chen Wang Chen Wang Chen Wang Chen Wang |
| author_facet | Ziying Chen Ziying Chen Ziying Chen Ziying Chen Ziying Chen Ziying Chen Qingyuan Zhan Qingyuan Zhan Qingyuan Zhan Qingyuan Zhan Qingyuan Zhan Qingyuan Zhan Linna Huang Linna Huang Linna Huang Linna Huang Linna Huang Chen Wang Chen Wang Chen Wang Chen Wang Chen Wang Chen Wang Chen Wang |
| author_sort | Ziying Chen |
| collection | DOAJ |
| description | BackgroundSimilar to influenza, coinfections and superinfections are common and might result in poor prognosis. Our study aimed to compare the characteristics and risks of coinfections and superinfections in severe COVID-19 and influenza virus pneumonia.MethodsThe data of patients with COVID-19 and influenza admitted to the intensive care unit (ICU) were retrospectively analyzed. The primary outcome was to describe the prevalence and pathogenic distribution of coinfections/ICU-acquired superinfections in the study population. The secondary outcome was to evaluate the independent risk factors for coinfections/ICU-acquired superinfections at ICU admission. Multivariate analysis of survivors and non-survivors was performed to investigate whether coinfections/ICU-acquired superinfections was an independent prognostic factor.ResultsIn the COVID-19 (n = 123) and influenza (n = 145) cohorts, the incidence of coinfections/ICU-acquired superinfections was 33.3%/43.9 and 35.2%/52.4%, respectively. The most common bacteria identified in coinfection cases were Enterococcus faecium, Pseudomonas aeruginosa, and Acinetobacter baumannii (COVID-19 cohort) and A. baumannii, P. aeruginosa, and Klebsiella pneumoniae (influenza cohort). A significant higher proportion of coinfection events was sustained by Aspergillus spp. [(22/123, 17.9% in COVID-19) and (18/145, 12.4% in influenza)]. The COVID-19 group had more cases of ICU-acquired A. baumannii, Corynebacterium striatum and K. pneumoniae. A. baumannii, P. aeruginosa, and K. pneumoniae were the three most prevalent pathogens in the influenza cases with ICU-acquired superinfections. Patients with APACHE II ≥18, CD8+ T cells ≤90/μL, and 50 < age ≤ 70 years were more susceptible to coinfections; while those with CD8+ T cells ≤90/μL, CRP ≥120 mg/L, IL-8 ≥ 20 pg./mL, blood glucose ≥10 mmol/L, hypertension, and smoking might had a higher risk of ICU-acquired superinfections in the COVID-19 group. ICU-acquired superinfection, corticosteroid administration for COVID-19 treatment before ICU admission, and SOFA score ≥ 7 were independent prognostic factors in patients with COVID-19.ConclusionPatients with COVID-19 or influenza had a high incidence of coinfections and ICU-acquired superinfections. The represent agents of coinfection in ICU patients were different from those in the general ward. These high-risk patients should be closely monitored and empirically treated with effective antibiotics according to the pathogen. |
| first_indexed | 2024-03-12T12:18:09Z |
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| language | English |
| last_indexed | 2024-03-12T12:18:09Z |
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| series | Frontiers in Public Health |
| spelling | doaj.art-e6eb544f249248b393e630d0821bd5572023-08-30T08:52:05ZengFrontiers Media S.A.Frontiers in Public Health2296-25652023-08-011110.3389/fpubh.2023.11950481195048Coinfection and superinfection in ICU critically ill patients with severe COVID-19 pneumonia and influenza pneumonia: are the pictures different?Ziying Chen0Ziying Chen1Ziying Chen2Ziying Chen3Ziying Chen4Ziying Chen5Qingyuan Zhan6Qingyuan Zhan7Qingyuan Zhan8Qingyuan Zhan9Qingyuan Zhan10Qingyuan Zhan11Linna Huang12Linna Huang13Linna Huang14Linna Huang15Linna Huang16Chen Wang17Chen Wang18Chen Wang19Chen Wang20Chen Wang21Chen Wang22Chen Wang23Peking University China-Japan Friendship School of Clinical Medicine, Beijing, ChinaNational Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, ChinaState Key Laboratory of Respiratory Health and Multimorbidity, China-Japan Friendship Hospital, Beijing, ChinaNational Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, ChinaInstitute of Respiratory Medicine, Chinese Academy of Medical Sciences, China-Japan Friendship Hospital, Beijing, ChinaDepartment of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, ChinaPeking University China-Japan Friendship School of Clinical Medicine, Beijing, ChinaNational Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, ChinaState Key Laboratory of Respiratory Health and Multimorbidity, China-Japan Friendship Hospital, Beijing, ChinaNational Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, ChinaInstitute of Respiratory Medicine, Chinese Academy of Medical Sciences, China-Japan Friendship Hospital, Beijing, ChinaDepartment of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, ChinaNational Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, ChinaState Key Laboratory of Respiratory Health and Multimorbidity, China-Japan Friendship Hospital, Beijing, ChinaNational Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, ChinaInstitute of Respiratory Medicine, Chinese Academy of Medical Sciences, China-Japan Friendship Hospital, Beijing, ChinaDepartment of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, ChinaPeking University China-Japan Friendship School of Clinical Medicine, Beijing, ChinaNational Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, ChinaState Key Laboratory of Respiratory Health and Multimorbidity, China-Japan Friendship Hospital, Beijing, ChinaNational Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, ChinaInstitute of Respiratory Medicine, Chinese Academy of Medical Sciences, China-Japan Friendship Hospital, Beijing, ChinaDepartment of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, ChinaChinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaBackgroundSimilar to influenza, coinfections and superinfections are common and might result in poor prognosis. Our study aimed to compare the characteristics and risks of coinfections and superinfections in severe COVID-19 and influenza virus pneumonia.MethodsThe data of patients with COVID-19 and influenza admitted to the intensive care unit (ICU) were retrospectively analyzed. The primary outcome was to describe the prevalence and pathogenic distribution of coinfections/ICU-acquired superinfections in the study population. The secondary outcome was to evaluate the independent risk factors for coinfections/ICU-acquired superinfections at ICU admission. Multivariate analysis of survivors and non-survivors was performed to investigate whether coinfections/ICU-acquired superinfections was an independent prognostic factor.ResultsIn the COVID-19 (n = 123) and influenza (n = 145) cohorts, the incidence of coinfections/ICU-acquired superinfections was 33.3%/43.9 and 35.2%/52.4%, respectively. The most common bacteria identified in coinfection cases were Enterococcus faecium, Pseudomonas aeruginosa, and Acinetobacter baumannii (COVID-19 cohort) and A. baumannii, P. aeruginosa, and Klebsiella pneumoniae (influenza cohort). A significant higher proportion of coinfection events was sustained by Aspergillus spp. [(22/123, 17.9% in COVID-19) and (18/145, 12.4% in influenza)]. The COVID-19 group had more cases of ICU-acquired A. baumannii, Corynebacterium striatum and K. pneumoniae. A. baumannii, P. aeruginosa, and K. pneumoniae were the three most prevalent pathogens in the influenza cases with ICU-acquired superinfections. Patients with APACHE II ≥18, CD8+ T cells ≤90/μL, and 50 < age ≤ 70 years were more susceptible to coinfections; while those with CD8+ T cells ≤90/μL, CRP ≥120 mg/L, IL-8 ≥ 20 pg./mL, blood glucose ≥10 mmol/L, hypertension, and smoking might had a higher risk of ICU-acquired superinfections in the COVID-19 group. ICU-acquired superinfection, corticosteroid administration for COVID-19 treatment before ICU admission, and SOFA score ≥ 7 were independent prognostic factors in patients with COVID-19.ConclusionPatients with COVID-19 or influenza had a high incidence of coinfections and ICU-acquired superinfections. The represent agents of coinfection in ICU patients were different from those in the general ward. These high-risk patients should be closely monitored and empirically treated with effective antibiotics according to the pathogen.https://www.frontiersin.org/articles/10.3389/fpubh.2023.1195048/fullCOVID-19influenzacoinfectionICU-acquired superinfectionbacteria |
| spellingShingle | Ziying Chen Ziying Chen Ziying Chen Ziying Chen Ziying Chen Ziying Chen Qingyuan Zhan Qingyuan Zhan Qingyuan Zhan Qingyuan Zhan Qingyuan Zhan Qingyuan Zhan Linna Huang Linna Huang Linna Huang Linna Huang Linna Huang Chen Wang Chen Wang Chen Wang Chen Wang Chen Wang Chen Wang Chen Wang Coinfection and superinfection in ICU critically ill patients with severe COVID-19 pneumonia and influenza pneumonia: are the pictures different? Frontiers in Public Health COVID-19 influenza coinfection ICU-acquired superinfection bacteria |
| title | Coinfection and superinfection in ICU critically ill patients with severe COVID-19 pneumonia and influenza pneumonia: are the pictures different? |
| title_full | Coinfection and superinfection in ICU critically ill patients with severe COVID-19 pneumonia and influenza pneumonia: are the pictures different? |
| title_fullStr | Coinfection and superinfection in ICU critically ill patients with severe COVID-19 pneumonia and influenza pneumonia: are the pictures different? |
| title_full_unstemmed | Coinfection and superinfection in ICU critically ill patients with severe COVID-19 pneumonia and influenza pneumonia: are the pictures different? |
| title_short | Coinfection and superinfection in ICU critically ill patients with severe COVID-19 pneumonia and influenza pneumonia: are the pictures different? |
| title_sort | coinfection and superinfection in icu critically ill patients with severe covid 19 pneumonia and influenza pneumonia are the pictures different |
| topic | COVID-19 influenza coinfection ICU-acquired superinfection bacteria |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2023.1195048/full |
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