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Predictors of respiratory bacterial co-infection in hospitalized COVID-19 patients

Austin Bolker1, Kelci Coe2, Jessica Smith3

  • 1Department of Pharmacy, The Ohio State University Wexner Medical Center, Columbus, OH, USA.

Diagnostic Microbiology and Infectious Disease
|November 3, 2021
PubMed

Insights

Respiratory bacterial co-infection in COVID-19 inpatients was uncommon (11.2%), but associated with increased antibiotic use. Identifying predictors like SNF/LTAC/NH admission, severe COVID-19, and leukocytosis can guide antibiotic prescribing.

Area of Science:

  • Infectious Diseases
  • Pulmonology
  • Critical Care Medicine

Background:

  • Bacterial co-infections complicate viral respiratory illnesses, including COVID-19.
  • Understanding the prevalence and risk factors for bacterial co-infection in COVID-19 is crucial for appropriate management.

Purpose of the Study:

  • To determine the prevalence of respiratory bacterial co-infection in hospitalized COVID-19 patients.
  • To identify variables associated with bacterial co-infection.
  • To assess the impact of co-infection on antibiotic use, length of stay, and mortality.

Main Methods:

  • Retrospective analysis of 735 COVID-19 inpatients.
  • Case-control study matching 57 patients with co-infection to 228 controls without co-infection.
  • Multivariable logistic regression to identify risk factors for co-infection.

Main Results:

  • Respiratory bacterial co-infection was present in 11.2% of patients.
  • Co-infected patients received antibiotics more frequently (100% vs 76%) and for longer durations.
  • Risk factors for co-infection included admission from skilled nursing facilities/long-term acute care/nursing homes, severe COVID-19, and leukocytosis.

Conclusions:

  • Respiratory bacterial co-infection is relatively rare in COVID-19 inpatients but warrants consideration.
  • Predictors of co-infection can inform empiric antibiotic prescribing strategies.
  • Further research may optimize antibiotic stewardship in this population.
Keywords:
COVID-19co-infectionpneumonia

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