Risk Factors Associated with the Development of Hospital-Acquired Infections in Hospitalized Patients with Severe COVID-19
Abstract
:1. Introduction
2. Results
3. Discussion
4. Materials and Methods
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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All Patients n = 1540 (100%) | Developed HAI n = 221 (14.35%) | Did Not Develop HAI n = 1319 (85.65%) | p | |
---|---|---|---|---|
Male sex, n (%) | 941 (61.1) | 159 (72.0) | 782 (59.3) | <0.001 |
Age, years—median (IQR) | 55 (45–65) | 56 (46–65) | 54 (45–66) | 0.633 |
Obesity—n (%) n = 1537 | 681 (44.3) | 120 (54.3) n = 221 | 561 (42.3) n = 1316 | 0.001 |
Type 2 diabetes mellitus—n (%) n = 1539 | 440 (28.6) | 68 (30.8) n = 221 | 372 (28.2) n = 1318 | 0.438 |
Hypertension—n (%) n = 1359 | 528 (34.3) | 69 (31.2) n = 221 | 459 (34.8) n = 1318 | 0.296 |
Chronic obstructive pulmonary disease—n (%) n = 1539 | 22(1.4) | 1 (0.5) n = 221 | 21 (1.6) n = 1318 | 0.351 |
Immunosuppression—n (%) n = 1538 | 87 (5.7) | 13 (5.9) n = 220 | 74 (5.6) n = 1318 | 0.861 |
Cardiovascular disease—n (%) n = 1538 | 86 (5.6) | 14 (6.4) n = 220 | 72 (5.5) n = 1318 | 0.590 |
Chronic kidney disease—n (%) n = 1539 | 51 (3.3) | 8 (3.6) n = 221 | 43 (3.3) n = 1318 | 0.838 |
Liver cirrhosis—n (%) n = 1536 | 11 (0.7) | 1 (0.5) n = 221 | 10 (0.8) n = 1315 | 1.000 |
Charlson comorbidity index >2—n (%) | 482 (31.3) | 70 (31.7) | 412 (31.2) | 0.897 |
Time from symptom onset to hospital admission, days—median (IQR) | 7 (5–10) | 7 (5–9) | 7 (5–10) | 0.974 |
Oxygen saturation <90%, n (%) n = 1510 | 1371 (90.8) | 206 (97.2) n = 212 | 1165 (89.8) n = 1298 | <0.001 |
Lymphocyte count <800 cells/uL%—n (%) | 855 (55.9) | 142 (64.8) n = 219 | 713 (54.4) n = 1311 | 0.004 |
C-reactive protein >10 mg/dL—n (%) n = 1498 | 1030 (68.8) | 187 (86.6), n = 216 | 843 (65.8) n = 1282 | <0.001 |
Ferritin >500 ng/mL—n (%) n = 1487 | 828 (55.7) | 151 (72.3) n = 209 | 677 (53.0) n = 1278 | <0.001 |
Lactate dehydrogenase ≥246 U/L—n (%) n = 1482 | 1285 (84.9) | 198 (93.0) n = 213 | 1060 (83.5) n = 1269 | <0.001 |
D-dimer >500 ng/mL—n (%) n = 1500 | 555 (37.0) | 99 (46.1) n = 215 | 456 (35.5) n = 1285 | 0.003 |
Multilobe involvement in CT—n (%) n = 1538 | 1530 (99.5) | 221 (100) n = 221 | 1309 (99.4) n = 1317 | 0.288 |
Use of invasive mechanical ventilation in the first 24 h—n (%) | 279 (68.1) | 143 (64.7) | 136 (10.3) | <0.001 |
Empiric antibiotic therapy—n (%) | 914 (59.4) | 136 (61.5) | 778 (59.0) | 0.474 |
Treatment with steroids—n (%) | 688 (44.7) | 139 (62.9) | 549 (41.6) | <0.001 |
Treatment with tocilizumab—n (%) | 97 (6.3) | 21 (9.5) | 76 (5.8) | 0.034 |
Enrollment in a COVID-19 clinical trial—n (%) | 320 (20.8) | 26 (11.8) | 294 (22.3) | <0.001 |
aOR (CI 95%) p * | |
---|---|
Use of IMV in the first 24 h after admission | 18.78 (12.56–28.07) p < 0.0001 |
Chronic kidney disease | 3.41 (1.40–8.27) p = 0.007 |
Corticosteroid treatment | 2.95 (1.92–4.53) p < 0.0001 |
Tocilizumab treatment | 2.69 (1.38–5.22) p = 0.004 |
Age > 60 years | 1.91 (1.27–2.88) p = 0.002 |
Male sex | 1.52 (1.03–2.24) p = 0.031 |
Obesity | 1.49 (1.03–2.15) p = 0.031 |
Immunosuppression | 1.59 (0.75–3.35) p = 0.222 |
Cardiovascular disease | 1.12 (0.52–2.39) p = 0.762 |
Diabetes mellitus | 1.03 (0.68–1.54) p = 0.882 |
Empirical antibiotic therapy | 1.00 (0.64–1.55) p = 0.993 |
Enrollment in a clinical trial | 0.98 (0.59–1.64) p = 0.958 |
Oxygen saturation <90% | 0.95 (0.33–2.69) p = 0.924 |
Hypertension | 0.69 (0.46–1.05) p = 0.091 |
Chronic obstructive pulmonary disease | 0.12 (0.01–1.05) p = 0.056 |
* 1429 observations, PseudoR2 = 0.2937. |
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Solís-Huerta, F.; Martinez-Guerra, B.A.; Roman-Montes, C.M.; Tamez-Torres, K.M.; Rajme-Lopez, S.; Ortíz-Conchi, N.; López-García, N.I.; Villalobos-Zapata, G.Y.; Rangel-Cordero, A.; Santiago-Cruz, J.; et al. Risk Factors Associated with the Development of Hospital-Acquired Infections in Hospitalized Patients with Severe COVID-19. Antibiotics 2023, 12, 1108. https://doi.org/10.3390/antibiotics12071108
Solís-Huerta F, Martinez-Guerra BA, Roman-Montes CM, Tamez-Torres KM, Rajme-Lopez S, Ortíz-Conchi N, López-García NI, Villalobos-Zapata GY, Rangel-Cordero A, Santiago-Cruz J, et al. Risk Factors Associated with the Development of Hospital-Acquired Infections in Hospitalized Patients with Severe COVID-19. Antibiotics. 2023; 12(7):1108. https://doi.org/10.3390/antibiotics12071108
Chicago/Turabian StyleSolís-Huerta, Fernando, Bernardo Alfonso Martinez-Guerra, Carla Marina Roman-Montes, Karla Maria Tamez-Torres, Sandra Rajme-Lopez, Narciso Ortíz-Conchi, Norma Irene López-García, Guadalupe Yvonne Villalobos-Zapata, Andrea Rangel-Cordero, Janet Santiago-Cruz, and et al. 2023. "Risk Factors Associated with the Development of Hospital-Acquired Infections in Hospitalized Patients with Severe COVID-19" Antibiotics 12, no. 7: 1108. https://doi.org/10.3390/antibiotics12071108
APA StyleSolís-Huerta, F., Martinez-Guerra, B. A., Roman-Montes, C. M., Tamez-Torres, K. M., Rajme-Lopez, S., Ortíz-Conchi, N., López-García, N. I., Villalobos-Zapata, G. Y., Rangel-Cordero, A., Santiago-Cruz, J., Xancal-Salvador, L. F., Méndez-Ramos, S., Ochoa-Hein, E., Galindo-Fraga, A., Ponce-de-Leon, A., Gonzalez-Lara, M. F., & Sifuentes-Osornio, J. (2023). Risk Factors Associated with the Development of Hospital-Acquired Infections in Hospitalized Patients with Severe COVID-19. Antibiotics, 12(7), 1108. https://doi.org/10.3390/antibiotics12071108