Table 1.
Bacterial co-infection in mechanically ventilated adults with severe viral pneumonia.
| Influenza (n = 24) | SARS-Cov-2 (n = 36) | ||||
|---|---|---|---|---|---|
| Patient characteristics | |||||
| Age, median (IQR) | 56 (47–63) | 59 (51–65) | p = 0.29 | ||
| Male, n (%) | 15 (63%) | 25 (69%) | p = 0.59 | ||
| Severe immunosuppression, n (%) | 2 (8%) | 2 (6%) | P>0.99 | ||
| Systemic corticosteroids last 21 days, n (%) | 7 (29%) | 4 (11%) | p = 0.097 | ||
| Chronic Lung Disease, n (%) | 7 (29%) | 4 (11%) | p = 0.097 | ||
| Chronic Kidney Disease, n (%) | 1 (4%) | 3 (8%) | p = 0.64 | ||
| Diabetes, n (%) | 4 (17%) | 12 (33%) | p = 0.23 | ||
| Hypertension, n (%) | 5 (21%) | 13 (36%) | p = 0.26 | ||
| Active / Past Smoker, n (%) | 11 (46%) | 14 (39%) | p = 0.61 | ||
| Duration of symptoms (days), median (IQR) | 5 (2–7) | 9 (6–11) | p = 0.0018 | ||
| Admission SOFA score, median (IQR) | 10 (9–13) | 6 (4–8) | p<0.0001 | ||
| Admission APACHE 2 score, median (IQR) | 22 (17–27) | 14 (11–19) | p<0.0001 | ||
| Lymphocyte: Neutrophil ratio, median (IQR) | 112 (7–20) | 13 (6–18) | p = 0.85 | ||
| Diagnostic sampling, no of patients (%) | |||||
| Respiratory tract sampling | 24 (100%) | 36 (100%) | p>0.99 | ||
| Bronchoalveolar lavage | 19 (79%) | 3 (8%) | P<0.0001 | ||
| Urine legionella Antigen | 19 (79%) | 30 (83%) | p = 0.74 | ||
| Urine pneumococcal Antigen | 20 (83%) | 27 (75%) | p = 0.53 | ||
| Blood culture | 24 (100%) | 36 (100%) | p>0.99 | ||
| Mycoplasma serology/PCR | 20 (83%) | 7 (19%) | P<0.0001 | ||
| Interventions and Outcomes | |||||
| Renal replacement therapy, n (%) | 15 (63%) | 15 (42%) | p = 0.19 | ||
| Extra Corporeal Membrane Oxygenation, n (%) | 11 (46%) | 0 (0%) | P<0.0001 | ||
| Days ventilated, median (IQR) | 16 (9–28) | 18 (12–27) | p = 0.62 | ||
| Days on ICU, median (IQR) | 22 (16–32) | 20 (16–31) | p = 0.97 | ||
| 90 day all-cause mortality, n (%) | 4 (17%) | 18 (50%) | p = 0.013 | ||
| Bacterial coinfection | |||||
| Early (<48 h of ICU admission), n (%) | 14 (58%) | 3 (8%) | P<0.0001 | ||
| Late (>48 h of ICU admission), n (%) | 12 (50%) | 13 (36%) | p = 0.30 | ||
| Gram positive | Early | Late | Early | Late | |
| Streptococcus pneumoniae | 2 | 0 | 0 | 0 | |
| Staphylococcus aureus | 2 | 0 | 1 | 1 | |
| Streptococcus pyogenes (Group A Strep) | 2 | 0 | 0 | 0 | |
| Enterococci | 0 | 1 | 1 | 0 | |
| Gram negative | Early | Late | Early | Late | |
| Haemophilus influenzae | 1 | 1 | 0 | 0 | |
| Coliforms | 1 | 5 | 0 | 9 | |
| Pseudomonas | 1 | 1 | 0 | 1 | |
| Other | 5 | 4 | 1 | 2 | |
Influenza; A not subtyped (n = 9), H1N1 (n = 10), H3N2 (n = 4), B (n = 1). Coliforms; Klebsiella, Escherichia coli, Citrobacter, Enterobacter, Serratia. Other; Proteus, Stenotrophomonas, polymicrobial. Respiratory tract sampling; sputum, bronchoalveolar lavage, non-directed lavage, endotracheal aspirate. p values calculated using Fisher's exact test for categorical and Mann-Whitney U test for continuous variables using GraphPad Prism 8.4.2. SOFA/Apache 2 scores calculated using www.mdcalc.com.