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Article

Correlation between Previous Antibiotic Exposure and COVID-19 Severity. A Population-Based Cohort Study

1
Fundació Institut Universitari per la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain
2
Department of Public Health, General Practice, University of Southern Denmark, 5000 Odense, Denmark
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Universitat Autònoma de Barcelona, Bellaterra, 08193 Cerdanyola del Vallès, Spain
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Section and Research Unit of General Practice, Department of Public Health, University of Copenhagen, 1014 Copenhagen, Denmark
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Departament de Farmacologia, Terapèutica i Toxicologia, Universitat Autònoma de Barcelona, Bellaterra, 08193 Cerdanyola del Vallès, Spain
6
Plataforma SCReN, IICEC IDIAP Jordi Gol, 08007 Barcelona, Spain
*
Author to whom correspondence should be addressed.
Academic Editors: Nicholas Dixon, Mehran Monchi and Marc Maresca
Antibiotics 2021, 10(11), 1364; https://doi.org/10.3390/antibiotics10111364
Received: 10 September 2021 / Revised: 25 October 2021 / Accepted: 5 November 2021 / Published: 8 November 2021
(This article belongs to the Special Issue Antibiotics Use in Primary Care during COVID-19)
We examined the correlation between previous antibiotic exposure and COVID-19 severity using a population-based observational matched cohort study with patient level data obtained for more than 5.8 million people registered in SIDIAP in Catalonia, Spain. We included all patients newly diagnosed with COVID-19 from March to June 2020 and identified all their antibiotic prescriptions in the previous two years. We used a composite severity endpoint, including pneumonia, hospital admission and death due to COVID-19. We examined the influence of high antibiotic exposure (>4 regimens), exposure to highest priority critically important antimicrobials (HPCIA) and recent exposure. Potential confounders were adjusted by logistic regression. A total of 280,679 patients were diagnosed with COVID-19, 146,656 of whom were exposed to at least one antibiotic course (52.3%) during the preceding two years. A total of 25,222 presented severe COVID-19 infection (9%), and the risk of severity was highest among those exposed to antibiotics (OR 1.12; 95% CI: 1.04–1.21). Among all individuals exposed to antibiotics, high, recent and exposure to HPCIAs were correlated with increased COVID severity (OR 1.19; 95% CI: 1.14–1.26; 1.41; 95% CI: 1.36–1.46; and 1.35; 95% CI: 1.30–1.40, respectively). Our findings confirm a significant correlation between previous antibiotic exposure and increased severity of COVID-19 disease. View Full-Text
Keywords: drug resistance; microbial; primary health care; COVID-19; anti-bacterial agents drug resistance; microbial; primary health care; COVID-19; anti-bacterial agents
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MDPI and ACS Style

Llor, C.; Ouchi, D.; Giner-Soriano, M.; García-Sangenís, A.; Bjerrum, L.; Morros, R. Correlation between Previous Antibiotic Exposure and COVID-19 Severity. A Population-Based Cohort Study. Antibiotics 2021, 10, 1364. https://doi.org/10.3390/antibiotics10111364

AMA Style

Llor C, Ouchi D, Giner-Soriano M, García-Sangenís A, Bjerrum L, Morros R. Correlation between Previous Antibiotic Exposure and COVID-19 Severity. A Population-Based Cohort Study. Antibiotics. 2021; 10(11):1364. https://doi.org/10.3390/antibiotics10111364

Chicago/Turabian Style

Llor, Carl, Dan Ouchi, Maria Giner-Soriano, Ana García-Sangenís, Lars Bjerrum, and Rosa Morros. 2021. "Correlation between Previous Antibiotic Exposure and COVID-19 Severity. A Population-Based Cohort Study" Antibiotics 10, no. 11: 1364. https://doi.org/10.3390/antibiotics10111364

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