Investigation of microbial coinfection in 453 septic COVID-19 patients admitted to hospital; a retrospective study

Armin Khavandegar; Zeinab Siami; Sogand Goudarzi; Aziz Rasooli; Yeganeh Ettehad

doi:10.2144/fsoa-2023-0066

Investigation of microbial coinfection in 453 septic COVID-19 patients admitted to hospital; a retrospective study

Future Sci OA. 2023 Jul 29;9(9):FSO884. doi: 10.2144/fsoa-2023-0066. eCollection 2023 Oct.

Authors

Armin Khavandegar¹, Zeinab Siami^{2

3}, Sogand Goudarzi⁴, Aziz Rasooli⁵, Yeganeh Ettehad⁶

Affiliations

¹ Sina Trauma & Surgery Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
² Infectious Disease Department, Alborz University of Medical Sciences, Karaj, Iran.
³ Department of Infectious Diseases & Tropical Medicine, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran.
⁴ Department of Anesthesiology & Perioperative Medicine, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA.
⁵ Department of Emergency Medicine, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
⁶ Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran.

Abstract

Aim: We evaluated the rate of COVID-19 microbial coinfection in an Iranian population.

Methods: In this single-center, retrospective observational study, we evaluated 453 septic COVID-19 patients for possible coinfection in an Iranian hospital.

Results: Overall, 211 (46.57%) cases died due to COVID-19 complications. Positive respiratory secretion and blood cultures were reported in 99 (21.9%) and 19 (4.2%) cases. Klebsiella species were the most commonly isolated microorganisms in respiratory (n = 50, 50.5%) and blood (n = 10, 52.6%) specimens. After adjustment for underlying disorders, positive respiratory microbial cultures significantly increase the odds of developing death, intubation, and ICU admission and negatively impact healthy discharge (P < 0.05).

Conclusion: Coinfections with bacteria and fungi independently contribute to poor outcomes in septic COVID-19 patients.

Keywords: COVID-19; SARS-CoV-2; bacterial coinfection; coinfection; underlying disease.

Plain language summary

COVID-19 bacterial/fungal coinfection is associated with severe mortality rates as it complicates the primary viral infection. This study evaluated 453 patients admitted to an Iranian hospital with COVID-19 and concomitant sepsis for microbial coinfection. A total of 99 (21.9%) cases had positive respiratory secretion cultures, and 19 (4.2%) had positive blood cultures. Klebsiella species were the most commonly yielded microorganism in both respiratory (n = 50, 50.5%) and blood (n = 10, 52.6%) specimens. Bacterial and fungal microbial coinfection are independent determinants of poor outcomes in septic COVID-19 cases.