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Published on: December 10, 2016
The Impact of Clostridioides Difficile Infection in Hospitalized Patients: What Changed during the Pandemic?
Alina Boeriu1,2, Adina Roman1,2, Daniela Dobru1,2
1Gastroenterology Department, University of Medicine Pharmacy, Sciences, and Technology "George Emil Palade" Targu Mures, 540142 Targu Mures, Romania.
Insights
Concurrent infections with Clostridioides difficile (C. difficile) and SARS-CoV-2 significantly worsen patient outcomes. The COVID-19 pandemic exacerbated C. difficile risks, leading to increased ICU stays and mortality.
Area of Science:
- Infectious Diseases
- Epidemiology
- Critical Care Medicine
Background:
- Clostridioides difficile (C. difficile) infection and SARS-CoV-2 pose significant global health challenges.
- The COVID-19 pandemic introduced unprecedented changes in healthcare delivery and patient risk factors.
- Understanding the impact of concurrent infections is crucial for managing patient outcomes.
Purpose of the Study:
- To evaluate the impact of concurrent Clostridioides difficile infection (CDI) and COVID-19 on patient outcomes.
- To compare risk factors and negative outcomes for patients with CDI alone versus those with CDI and COVID-19.
- To identify prognostic indicators for patients experiencing these co-infections.
Main Methods:
- Retrospective analysis of patients admitted before and during the COVID-19 pandemic.
- Inclusion criteria: patients diagnosed with CDI.
- Comparison of risk factors (antibiotics, corticosteroids) and outcomes (ICU care, hospitalization duration, organ failure, death).
Main Results:
- 188 patients analyzed: 100 with CDI (pre-pandemic), 88 with CDI and COVID-19 (pandemic).
- Pandemic group patients were older, had higher Charlson Comorbidity Index (CCI), and greater exposure to antibiotics/corticosteroids.
- Concurrent CDI and COVID-19 led to increased organ dysfunction, ICU admission, and prolonged hospitalization.
Conclusions:
- Concurrent infections, particularly CDI and COVID-19, negatively impact patient prognosis.
- COVID-19 severity is a direct determinant of outcomes in patients with co-infections.
- Higher CCI and leukocytosis are associated with poor outcomes in both CDI alone and co-infected patients.
Abstract:
(1) Background: Clostridioides difficile (C. difficile) and SARS-CoV-2 coronavirus represent significant health threats. Our study focused on the impact of concurrent infections on patient outcomes against the backdrop of changes imposed by the pandemic. (2) Materials and methods. We performed a retrospective analysis and included patients diagnosed with CDI who were admitted in our hospital before and during the pandemic. We compared patient exposure to risk factors for CDI in both groups and patient negative outcomes: need for ICU care, prolonged hospitalization, organ failure, toxic megacolon, and death. (3) Results. Overall, 188 patients were included, of which 100 had CDI (the pre-pandemic group), and 88 patients presented both CDI and COVID-19 (the pandemic group). Patients in the pandemic group were significantly older, with a higher Charlson Comorbidity Index (CCI) and a greater exposure to antibiotics and corticosteroids, and were more likely to develop organ dysfunction, to require ICU care and have prolonged hospitalization. The severity of COVID-19, leukocytosis and increased D-dimer levels were indicators of poor prognosis in the pandemic group. Higher CCI scores and leukocytosis increased the risk for negative outcomes in CDI alone patients. (4) Conclusions. The study highlights the negative impact of associated infections on patient outcome. The severity of COVID-19 directly influences the prognosis of patients with concurrent infections.
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