Investigation of Microbial Coinfection in 453 Septic COVID-19 Patients Admitted to hospital; a Retrospective Study

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.

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.

Keywords:

• bacterial coinfection
• coinfection
• COVID-19
• SARS-CoV-2
• underlying disease

Author contributions

A Khavandegar and Z Siami interpreted the data and reviewed and revised the article. S Goudarzi helped in manuscript drafting and editing. Y Ettehad and A Rasooli interpreted the data and drafted the manuscript. All authors have read and approved the manuscript.

Acknowledgments

The authors are grateful to all those involved in this project.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

This study is approved by the Research Ethics Committee of Alborz University of Medical Sciences with Approval ID: I.R.ABZUMS.REC.1400.080. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.