Patients with severe Covid-19 and a secondary blood infection were significantly sicker during hospital admission, and reported longer hospital stays with poorer outcomes, suggests a recent study.

The study, published in the journal Clinical Infectious Diseases, aimed to examine the microbiology, risk factors, and outcomes in hospitalized patients with severe Covid-19 and secondary bloodstream infections.

The researchers examined 375 patients diagnosed with severe Covid-19 from March to May 2020. Of that group, they sampled 128 cases that had secondary bloodstream infections, 92 per cent of which were bacterial infections.

Co-lead author Pinki Bhatt, an assistant professor at Rutgers Robert Wood Johnson Medical School's Division of Allergy, Immunology and Infectious Disease said, “These patients were more likely to have altered mental status, lower percent oxygen saturation, septic shock and to be admitted to the intensive care unit compared to those without bloodstream infections.”

Causes

The researchers also found that patients who required advanced supplemental oxygen after hospitalization had higher odds of secondary bloodstream infections.

The in-hospital mortality rate for these patients was more than 50 per cent. However, the study reported these deaths were associated with, not caused by, the condition.

The most common cause of secondary bloodstream infections was unknown or not determined followed by central-line associated bloodstream infection as the most common presumed source.

The study found that 80 per cent of all the patients in the study received antimicrobials at some point during hospitalization, including those who did not have bloodstream infections.

"This likely reflects clinicians' inclination to administer antimicrobials given the limited information on the natural course of this novel disease," Bhatt said.

"Antimicrobial stewardship remains crucial during this unprecedented time," said co-author Navaneeth Narayanan, a clinical associate professor at Rutgers Ernest Mario School of Pharmacy.

"Given the scale of the pandemic, indiscriminate antimicrobial use will inevitably lead to widespread complications such as adverse drug reactions, antimicrobial resistance, and Clostridium difficile infections," he added.

blood infection, coronavirus, COVID-19, hospitalization, health, pandemic