Risk factors for bacterial infections in patients with moderate to severe COVID‐19: A case‐control study

  1. Nosheen Nasir
  2. Fazal Rehman
  3. Syed Furrukh Omair

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Abstract

Adverse outcomes in coronavirus infection disease‐19 (COVID‐19) patients are not always due to the direct effects of the viral infection, but often due to bacterial coinfection. However, the risk factors for such bacterial coinfection are hitherto unknown. A case‐control study was conducted to determine risk factors for bacterial infection in moderate to critical COVID‐19. Out of a total of 50 cases and 50 controls, the proportion of cases with severe/critical disease at presentation was 80% in cases compared to 30% in controls ( p  < 0.001). The predominant site was hospital‐acquired pneumonia (72%) and the majority were Gram‐negative organisms (82%). The overall mortality was 30%, with comparatively higher mortality among cases (42% vs. 18%; p  = 0.009). There was no difference between procalcitonin levels in both groups ( p  = 0.883). In multivariable logistic regression analysis, significant independent association was found with severe/critical COVID‐19 at presentation (AOR: 4.42 times; 95% CI: 1.63–11.9) and use of steroids (AOR: 4.60; 95% CI: 1.24–17.05). Notably, 64% of controls were administered antibiotics despite the absence of bacterial coinfection or secondary infection. Risk factors for bacterial infections in moderate to critically ill patients with COVID‐19 include critical illness at presentation and use of steroids. There is widespread empiric antibiotic utilization in those without bacterial infection.

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  1. Version published to 10.1002/jmv.27000
  2. Version published to 10.21203/rs.3.rs-154681/v1 on Research Square
  3. ScreenIT

    SciScore for 10.1101/2021.01.09.21249498: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a protocol registration statement.

    About SciScore

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  4. Version published to 10.1101/2021.01.09.21249498 on medRxiv