Table 3.
Main characteristics of 82 patients with superinfections after 48 h of hospitalization for COVID-19.
| Characteristic | Patients without a superinfection N = 508 (%) | Patients with a superinfection N = 82 (%) | P value | Adjusted* OR (95% CI) | P value |
|---|---|---|---|---|---|
| Age, years (median, IQR) | 67 (40–84) | 47 (22–72) | 0.084 | 0.98 (0.95–1.00) | 0.011 |
| Male sex | 278 (54.7) | 55 (67.1) | 0.041 | 0.93 (0.45–1.92) | 0.85 |
| Hematological malignancy | 219 (43.1) | 47 (57.3) | 0.023 | 1.07 (0.49–2.31) | 0.85 |
| Lymphoma | 66 (13) | 19 (23.2) | |||
| Acute leukemia | 29 (5.7) | 9 (11) | |||
| Multiple myeloma | 52 (10.2) | 6 (7.3) | |||
| Myelodysplastic syndrome | 15 (3) | 1 (1.2) | |||
| Chronic lymphocytic leukemia | 40 (7.9) | 7 (8.5) | |||
| Hematopoietic stem cell transplant | 44 (20.1) | 6 (12.8) | |||
| Solid tumor | 289 (57) | 35 (42.7) | 0.023 | ||
| Lung cancer | 56 (19.4) | 7 (20) | |||
| Breast cancer | 60 (20.8) | 0 | |||
| Colorectal cancer | 53 (18.4) | 4 (11.4) | |||
| Prostate cancer | 22(7.6) | 6 (17.1) | |||
| Upper GI tract cancer | 19 (6.6) | 1 (2.9) | |||
| Urinary tract cancer | 16 (5.6) | 3 (8.6) | |||
| Gynecological cancer | 13 (4.5) | 5 (16.7) | |||
| Head and neck cancer | 9 (3.1) | 4 (11.4) | |||
| Hepatobiliary tumor | 15 (5.1) | 5 (14.3) | |||
| Other | 15 (5.1) | 0 | |||
| Comorbidities | |||||
| Hypertension | 241 (47.5) | 39 (47.6) | 1.00 | ||
| Diabetes mellitus | 99 (19.6) | 15 (18.3) | 0.88 | ||
| COPD | 37 (57.8) | 10 (55.6) | 1.00 | ||
| Chronic heart disease | 19 (3.7) | 4 (4.9) | 0.54 | ||
| Chronic renal disease | 14 (2.8) | 4 (4.9) | 0.30 | ||
| Immunosuppressive therapy | |||||
| Previous corticosteroids (1 m) | 130 (25.7) | 23 (28) | 0.68 | ||
| -Prednisone > 10 mg/day | 75 (58.6) | 13 (59.1) | 1.00 | ||
| Immunotherapy/targeted therapies | 114 (22.4) | 9 (11) | 0.018 | 0.50 (0.17–1.43) | 0.20 |
| Monoclonal antibodies | 29 (5.7) | 7 (8.5) | 0.32 | ||
| Neutropenia (< 500 cells/mm3) | 20 (4.2) | 8 (10.8) | 0.040 | 4.88 (1.35–17.5) | 0.015 |
| Inflammatory biomarkers (median, IQR) | |||||
| C-reactive protein (mg/L) | 65 (12–250) | 79.4 (13–381) | 0.16 | 1.00 (1.00–1.00) | 0.12 |
| Procalcitonin (μg/L) | 0.10 (0.02–3.94) | 0.24 (0.11–2.00) | 0.94 | ||
| Ferritin (μg/L)) | 1.247 (30–12.474) | 654 (466–11,330) | <0.001 | ||
| Creatine kinase (U/L) | 66 (16–296) | 85 (16–185) | 0.54 | ||
| Therapy | |||||
| Hydroxychloroquine | 375 (92.4) | 60 (83.3) | 0.023 | ||
| Lopinavir/ritonavir | 222 (54.7) | 44 (61.1) | 0.36 | ||
| Remdesivir | 15 (3.7) | 6 (8.2) | 0.11 | ||
| Tocilizumab | 75 (18.5) | 18 (25) | 0.20 | ||
| Corticosteroids | 185 (36.4) | 39 (48.1) | 0.049 | 2.03 (0.96–4.30) | 0.062 |
| Corticosteroids and/or immunomodulators | 204 (40.2) | 42 (51.9) | 0.053 | ||
| Antibacterial therapy | 414 (81.5) | 79 (97.5) | <0.001 | ||
| Amoxicillin-clavulanate | 52 (12.6) | 9 (11.4) | 0.85 | ||
| Broad-spectrum cephalosporins | 51 (12.3) | 16 (20.3) | 0.059 | ||
| Carbapenems | 67 (16.2) | 35 (44.3) | <0.001 | ||
| Quinolones | 25 (6) | 8 (10.1) | 0.21 | ||
| Piperacillin-tazobactam | 92 (22.2) | 29 (36.7) | 0.010 | ||
| Antifungal therapy | 9 (1.8) | 5 (6.2) | 0.032 | ||
| Acute respiratory distress syndrome | 158 (31.3) | 35 (44.3) | 0.028 | ||
| ICU admission | 51 (10.1) | 28 (35) | <0.001 | 4.98 (2.26–10.9) | <0.001 |
| Invasive mechanical ventilation | 30 (5.9) | 27 (33.8) | <0.001 | ||
| Overall in-hospital case-fatality rate | 157 (31.3) | 26 (32.5) | 0.89 | ||
| ICU-associated case-fatality rate | 23 (4.7) | 11 (14.1) | 0.003 |
ICU, intensive care unit. COPD, Chronic obstructive pulmonary disease; Broad-spectrum cephalosporins: cefepime, ceftazidime, ceftolozane-tazobactam and ceftazidime-avibactam; Antifungal therapy (more than one antifungal was administered in some patients): fluconazole (n = 5), voriconazole (n = 3), micafungin (n = 3), caspofungin (n = 2), anidulafungin (n = 2) posaconazole (n = 1), Amfotericin B (n = 1).