The Influence of Infection and Colonization on Outcomes in Inpatients With COVID-19: Are We Forgetting Something?

Area of Science:

• Epidemiology
• Infectious Diseases
• Hospital Management

Background:

• The COVID-19 pandemic severely impacted healthcare systems globally.
• Tertiary hospitals faced unprecedented challenges in managing patient care and preventing nosocomial infections.

Purpose of the Study:

• To investigate epidemiological factors associated with COVID-19 outcomes in a tertiary hospital.
• To identify risk factors for mortality, intensive care unit (ICU) admission, and nosocomial infections.

Main Methods:

• A prospective observational study was conducted over one year, following 2,448 patients.
• Data collected included comorbidities (Charlson Index), ICU stays, co-infections, colonizations, and nosocomial infections.
• Statistical analysis identified factors associated with increased mortality risk.

Main Results:

• Median time from symptom onset to diagnosis was 4 days, with an additional 4.4 days to ICU admission.
• Coinfection, especially with Candida auris (OR: 4.6), and ICU stay (OR: 3.18) significantly increased mortality risk.
• High Charlson Index scores and C. auris colonization were critical factors in both general hospitalization and ICU settings.

Conclusions:

• Coinfections and pre-existing comorbidities are critical risk factors for severe COVID-19 outcomes.
• Candida auris presents a significant threat, increasing mortality in COVID-19 patients, particularly those in the ICU.
• Effective management of comorbidities and prevention of C. auris colonization are crucial for improving patient survival.