Bacteremia is a greater risk factor for death, ICU admission, and mechanical ventilation than previously described risk factors for COVID-19 severity and mortality, such as older age, male gender, or various comorbidities. However, the frequency of bacteremic co-infection in COVID-19 and its impact on clinical outcomes are unclear.
To find out, the new study looked at COVID-19 inpatient encounters at UAB Hospital and Ochsner Louisiana State University Health Shreveport hospitals and divided them into three groups: bacterial co-infection as measured by a blood test within 48 hours of admission; suspected bacterial coinfection in patients receiving antimicrobials; and no bacterial co-infection.
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Although confirmed bacteremic co-infections in COVID-19 are rare, accounting for less than 4 percent of inpatient admissions, our results show that COVID-19 patients with these co-infections have a staggering 25 percent risk of death within 30 days in UAB patients. a similar risk of 20 percent.
Bacterial Coinfection: A Major Risk Factor for Mortality in COVID-19
These results indicate an underappreciated interaction between bacterial pathogens and the COVID-19 virus, SARS-CoV-2, and their impact on clinical outcomes.
Specifically, the researchers found that in-hospital mortality for COVID-19 co-infections was 26 percent in the UAB and 22 percent in the OLHS from suspected co-infection (UAB, 24 percent; OLHS, 12 percent) and no co-infection groups (UAB, 5.9 percent; OLHS, 5.1 percent).
Additionally, in a control group of 1,703 UAB inpatients with community-acquired bacteremia in the pre-COVID-19 pandemic, in-hospital mortality was 5.9 percent.
They also identified laboratory trends associated with a COVID-19 bacterial infection — a neutrophil-to-lymphocyte ratio of 15 or greater and criteria for Systemic Inflammatory Response Syndrome, or SIRS, an abnormal white blood cell count or an abnormal heart rate. 90 beats per minute.
These results highlight the role of bacteria in SARS-CoV-2 lethality and highlight the potential of the neutrophil-to-lymphocyte ratio as a rapid and readily available prognostic biomarker of bacterial coinfection and, accordingly, disease severity.
Source: Eurekalert
