TABLE 3.
Demographics and clinical characteristics of COVID-19 patients diagnosed with bacterial pneumonia during current or previous ICU stay periodsa
| Characteristic | Value for patients with pneumonia episodes from the: |
P value | |
|---|---|---|---|
| Current period (n = 97 patients; n = 122 episodes) | Previous period (n = 29 patients; n = 31 episodes) | ||
| Age (yrs) [median (IQR)] | 67 (60–72) | 65 (59–73) | 0.96 |
| Male [no. (%)] | 76 (78.4) | 27 (93.1) | 0.09 |
| Severity of illness at time of diagnosis [median (IQR)] | |||
| SOFA score | 5 (4–6) | 4 (3–6) | 0.09 |
| SAPS II | 38 (29–56) | 38 (33–47) | 0.84 |
| Length of stay in ICU (days) | 9 (5–17) | 18 (5–34) | <0.001 |
| Duration of mechanical ventilation (days) | 7 (1–13) | 10 (4–19) | 0.07 |
| Laboratory findings at time of diagnosis [median (IQR)]b | |||
| Procalcitonin level (ng/ml) | 0.38 (0.14–0.91) | 0.45 (0.11–2.2) | 0.77 |
| C-reactive protein level (mg/dl) | 150.5 (88.3–206.3) | 127.0 (47.8–188.2) | 0.10 |
| Serum ferritin level (ng/ml) | 986 (619–1641) | 1125 (501–2687) | 0.35 |
| WBC count (×109/liter) | 14.2 (9.8–19.1) | 13.2 (6.1–18.8) | 0.29 |
| Neutrophil count (×109/liter) | 12.6 (7.8–16.4) | 10.5 (5.2–17.3) | 0.41 |
| Clinical outcomes [no. with outcome/total no. (%)] | |||
| 14-day mortality | 45/122 (36.9) | 10/31 (32.3) | 0.41 |
| 28-day mortality | 73/122 (59.8) | 12/31 (38.7) | 0.05 |
| Effective antibiotic receipt within 6 h from respiratory tract sampling | 105/122 (86.1) | 6/31 (19.3) | <0.001 |
For comparison purposes, we included patients who had been hospitalized in the ICU during the first wave of COVID-19. We used the Mann-Whitney U test or Fisher’s exact test to analyze continuous (expressed as median with IQR) or categorical (expressed as number with percentage) variables between the two patient groups. These periods represent the periods with FA-PP panels implemented (current period, 24 September 2020 to 8 March 2021) or not implemented (previous period, 23 March 2020 to 30 June 2020) in routine clinical use. Exclusively using standard-of-care culture methods, Staphylococcus aureus, Pseudomonas aeruginosa, and Klebsiella pneumoniae were the most common etiological agents of bacterial pneumonia identified in the previous period studied. COVID-19, coronavirus disease 2019; ICU, intensive care unit; IQR, interquartile range; SOFA, sepsis-related organ failure assessment; SAPS II, simplified acute physiology score II; WBC, white blood cells.
For each biological parameter listed, level/count abnormality was assessed based on the reference value/range. The ranges were set as follows: procalcitonin, ≤0.1 ng/ml; C-reactive protein, ≤6 mg/dl; serum ferritin, 10 to 291 ng/ml; WBC, 4 × 109 to 11 × 109 cells/liter; and neutrophils, 2.0 × 109 to 7.5 × 109 cells/liter.