TY - JOUR
T1 - Impact of respiratory bacterial infections on mortality in Japanese patients with COVID-19
T2 - a retrospective cohort study
AU - The Japan COVID-19 Task Force
AU - Nakagawara, Kensuke
AU - Kamata, Hirofumi
AU - Chubachi, Shotaro
AU - Namkoong, Ho
AU - Tanaka, Hiromu
AU - Lee, Ho
AU - Otake, Shiro
AU - Fukushima, Takahiro
AU - Kusumoto, Tatsuya
AU - Morita, Atsuho
AU - Azekawa, Shuhei
AU - Watase, Mayuko
AU - Asakura, Takanori
AU - Masaki, Katsunori
AU - Ishii, Makoto
AU - Endo, Akifumi
AU - Koike, Ryuji
AU - Ishikura, Hiroyasu
AU - Takata, Tohru
AU - Matsushita, Yasushi
AU - Harada, Norihiro
AU - Kokutou, Hiroyuki
AU - Yoshiyama, Takashi
AU - Kataoka, Kensuke
AU - Mutoh, Yoshikazu
AU - Miyawaki, Masayoshi
AU - Ueda, Soichiro
AU - Ono, Hiroshi
AU - Ono, Takuya
AU - Shoko, Tomohisa
AU - Muranaka, Hiroyuki
AU - Kawamura, Kodai
AU - Mori, Nobuaki
AU - Mochimaru, Takao
AU - Fukui, Mototaka
AU - Chihara, Yusuke
AU - Nagasaki, Yoji
AU - Okamoto, Masaki
AU - Amishima, Masaru
AU - Odani, Toshio
AU - Tani, Mayuko
AU - Nishi, Koichi
AU - Shirai, Yuya
AU - Edahiro, Ryuya
AU - Ando, Akira
AU - Hashimoto, Naozumi
AU - Ogura, Shinji
AU - Kitagawa, Yuichiro
AU - Kita, Toshiyuki
AU - Kagaya, Takashi
N1 - Publisher Copyright:
© 2023, The Author(s).
PY - 2023/12
Y1 - 2023/12
N2 - Background: Although cases of respiratory bacterial infections associated with coronavirus disease 2019 (COVID-19) have often been reported, their impact on the clinical course remains unclear. Herein, we evaluated and analyzed the complication rates of bacterial infections, causative organisms, patient backgrounds, and clinical outcome in Japanese patients with COVID-19. Methods: We performed a retrospective cohort study that included inpatients with COVID-19 from multiple centers participating in the Japan COVID-19 Taskforce (April 2020 to May 2021) and obtained demographic, epidemiological, and microbiological results and the clinical course and analyzed the cases of COVID-19 complicated by respiratory bacterial infections. Results: Of the 1,863 patients with COVID-19 included in the analysis, 140 (7.5%) had respiratory bacterial infections. Community-acquired co-infection at COVID-19 diagnosis was uncommon (55/1,863, 3.0%) and was mainly caused by Staphylococcus aureus, Klebsiella pneumoniae and Streptococcus pneumoniae. Hospital-acquired bacterial secondary infections, mostly caused by Staphylococcus aureus, Pseudomonas aeruginosa, and Stenotrophomonas maltophilia, were diagnosed in 86 patients (4.6%). Severity-associated comorbidities were frequently observed in hospital-acquired secondary infection cases, including hypertension, diabetes, and chronic kidney disease. The study results suggest that the neutrophil–lymphocyte ratio (> 5.28) may be useful in diagnosing complications of respiratory bacterial infections. COVID-19 patients with community-acquired or hospital-acquired secondary infections had significantly increased mortality. Conclusions: Respiratory bacterial co-infections and secondary infections are uncommon in patients with COVID-19 but may worsen outcomes. Assessment of bacterial complications is important in hospitalized patients with COVID-19, and the study findings are meaningful for the appropriate use of antimicrobial agents and management strategies.
AB - Background: Although cases of respiratory bacterial infections associated with coronavirus disease 2019 (COVID-19) have often been reported, their impact on the clinical course remains unclear. Herein, we evaluated and analyzed the complication rates of bacterial infections, causative organisms, patient backgrounds, and clinical outcome in Japanese patients with COVID-19. Methods: We performed a retrospective cohort study that included inpatients with COVID-19 from multiple centers participating in the Japan COVID-19 Taskforce (April 2020 to May 2021) and obtained demographic, epidemiological, and microbiological results and the clinical course and analyzed the cases of COVID-19 complicated by respiratory bacterial infections. Results: Of the 1,863 patients with COVID-19 included in the analysis, 140 (7.5%) had respiratory bacterial infections. Community-acquired co-infection at COVID-19 diagnosis was uncommon (55/1,863, 3.0%) and was mainly caused by Staphylococcus aureus, Klebsiella pneumoniae and Streptococcus pneumoniae. Hospital-acquired bacterial secondary infections, mostly caused by Staphylococcus aureus, Pseudomonas aeruginosa, and Stenotrophomonas maltophilia, were diagnosed in 86 patients (4.6%). Severity-associated comorbidities were frequently observed in hospital-acquired secondary infection cases, including hypertension, diabetes, and chronic kidney disease. The study results suggest that the neutrophil–lymphocyte ratio (> 5.28) may be useful in diagnosing complications of respiratory bacterial infections. COVID-19 patients with community-acquired or hospital-acquired secondary infections had significantly increased mortality. Conclusions: Respiratory bacterial co-infections and secondary infections are uncommon in patients with COVID-19 but may worsen outcomes. Assessment of bacterial complications is important in hospitalized patients with COVID-19, and the study findings are meaningful for the appropriate use of antimicrobial agents and management strategies.
KW - Intensive care unit
KW - Invasive mechanical ventilation
KW - Mortality
KW - Neutrophil–lymphocyte ratio
KW - SARS-CoV-2 infection
UR - http://www.scopus.com/inward/record.url?scp=85153919482&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85153919482&partnerID=8YFLogxK
U2 - 10.1186/s12890-023-02418-3
DO - 10.1186/s12890-023-02418-3
M3 - Article
C2 - 37101265
AN - SCOPUS:85153919482
SN - 1471-2466
VL - 23
JO - BMC pulmonary medicine
JF - BMC pulmonary medicine
IS - 1
M1 - 146
ER -
