Table 2.
Univariate Analysis of Factors Associated with Superinfection in COVID-19 Patients Hospitalized in the ICU (Timișoara, Romania, October 2020–May 2021)
| Variable | Group 3 – Patients with Bacterial/ Fungal Infection (N3=119) | Group 4 – Patients Without Bacterial/Fungal Infection (N4=117) | p | OR [95% CI] |
|---|---|---|---|---|
| Age, years (median [IQR]) | 65.00[54.00–70.00] | 68.00[60.00–73.00] | 0.006 | 0.97[0.95–0.99] |
| Male gender [n (%)] | 70(58.82) | 69(58.97) | 0.981 | 0.99[0.59–1.67] |
| Days of hospitalization (median, [IQR]) | 11.00[7.00–15.00] | 8.00[5.00–12.00] | <0.001 | 1.12[1.06–1.19] |
| Days with CVC [median, IQR] | 10.00[4.00–14.00] | 4.00[2.00–8.00] | <0.001 | 1.15[1.09–1.21] |
| Days with peripheral venous catheter [median, IQR] | 0.00[0.00–2.00] | 1.00[0.00–5.00] | 0.004 | 0.89[0.82–0.96] |
| Days with urinary catheter [median, IQR] | 11.00[7.00–14.00] | 8.00[4.00–11.00] | <0.001 | 1.12[1.06–1.19] |
| Number of comorbidities [median, IQR] | 3.00[2.00–6.00] | 3.00[2.00–6.00] | 0.849 | 1.01[0.92–1.10] |
| Days of mechanical ventilation [median, IQR] | 6.00[1.00–10.00] | 3.00[1.00–6.00] | <0.001 | 1.15[1.08–1.23] |
| Days of non-invasive ventilation [median, IQR] | 1.00[0.00–6.00] | 2.00[0.00–6.00] | 0.528 | 0.98[0.91–1.05] |
| Days of O2 therapy – face mask [median, IQR] | 0.00[0.00–1.00] | 0.00[0.00–1.00] | 0.468 | 0.96[0.86–1.07] |
| O2 saturation [median, IQR] | 0.85[0.80–0.92] | 0.88[0.85–0.91] | 0.001 | 0.003[0.00–0.09] |
| Apache II score [median, IQR] | 12.00[9.00–18.00] | 12.00[8.00–17.00] | 0.801 | 1.00[0.97–1.04] |
| Carmeli score [median, IQR] | 2.00[2.00–2.00] | 2.00[2.00–2.00] | 0.081 | 1.81[0.93–3.54] |
| Charlson score [median, IQR] | 3.00[2.00–4.00] | 4.00[2.00–5.00] | 0.111 | 0.92[0.82–1.02] |
| Critical COVID-19 upon ICU admission [n, %] | 53(44.54) | 26(22.22) | <0.001 | 2.81[1.59–4.95] |
| Severe COVID-19 upon ICU admission [n, %] | 64(53.78) | 88(75.21) | <0.001 | 0.38[0.22–0.67] |
| Hiperimmune plasma administration [n, %] | 6(5.04) | 0(0) | 0.029 | Nedefinit |
| Prior corticosteroid treatment [n, %] | 101(84.87) | 81(69.23) | 0.004 | 2.49[1.32–4.71] |
| Tocilizumab [n, %] | 4(3.36) | 3(2.56) | 1.00 | 1.32[0.29–6.04] |
| ARDS [n, %] | 101(84.87) | 105(89.74) | 0.261 | 0.64[0.29–1.39] |
| COVID-19 organ damages | ||||
| Cardiac [n, %] | 20(16.81) | 13(11.11) | 0.260 | 1.61[0.76–3.42] |
| Hepatic [n, %] | 36(30.25) | 25(21.37) | 0.119 | 1.59[0.88–2.88] |
| Neurological [n, %] | 29(24.37) | 26(22.22) | 0.696 | 1.13[0.61–2.06] |
| Pancreatic [n, %] | 28(23.53) | 22(18.80) | 0.374 | 1.33[0.71–2.49] |
| Renal [n, %] | 24(20.17) | 27(23.08) | 0.587 | 0.84[0.45–1.57] |
| ALT (U/L) [median, IQR] | 39.00[23.00–69.00] | 38[29.00–63.00] | 0.332 | 0.99[0.99–1.00] |
| AST (U/L) [median, IQR] | 53.00[34.00–86.00] | 45.00[33.00–69.00] | 0.332 | 1.00[0.99–1.00] |
| Serum creatinin (mg/dL) [median, IQR] | 0.80[0.60–1.20] | 0.80[0.60–1.30] | 0.267 | 0.94[0.85–1.05] |
| D-Dimer (μg/mL) [median, IQR] | 834.00[428–2578] | 831.00[502–2745] | 0.708 | 1.00[1.00–1.00] |
| Fibrinogen (mg/dL) [median, IQR] | 452.00[345–591] | 452.00[303–588] | 0.427 | 1.00[0.99–1.00] |
| CRP (mg/L) [median, IQR] | 89.00[44.00–268.00] | 90.00[55.00–226.00] | 0.228 | 1.00[0.99–1.00] |
| Blood glucose (mg/dL) [median, IQR] | 170.00[131–225] | 168.00[137–243.00] | 0.064 | 0.99[0.99–1.00] |
| BMI (kg/m2) [median, IQR] | 27.00[23.60–31.00] | 28.00[24.00–35.60] | 0.144 | 0.97[0.93–1.01] |
| WBC (x1000/mm3) [median, IQR] | 17.20[12.50–4.90] | 17.80[13.10–5.50] | 0.642 | 1.00[0.99–1.00] |
| Procalcitonin (ng/mL) [median, IQR] | 0.50[0.50–1.50] | 0.50[0.50–0.50] | 0.020 | 1.12[1.02–1.24] |
| Hyperglicemia [n, %] | 89(74.79) | 99(84.62) | 0.060 | 0.54[0.28–1.03] |
| Comorbidities | ||||
| Cardiac disease [n, %] | 50(42.02) | 69(58.97) | 0.009 | 0.50[0.30–0.85] |
| Hypertension [n, %] | 79(66.39) | 82(70.09) | 0.542 | 0.84[0.49–1.46] |
| Cronic respiratory disease [n, %] | 17(14.29) | 15(12.82) | 0.742 | 1.13[0.54–2.39] |
| Chronic kidney disease [n, %] | 11(9.24) | 10(8.55) | 0.851 | 1.09[0.44–2.67] |
| Neurological/ neuromuscular disease [n, %] | 19(15.97) | 20(17.09) | 0.815 | 0.92[0.46–1.83] |
| Peptic ulcer disease [n, %] | 2(1.69) | 0(0) | 0.497 | Nedefinit |
| Coagulopathy [n, %] | 3(2.52) | 6(5.13) | 0.295 | 0.48[0.17–1.96] |
| Diabetes [n, %] | 37(31.09) | 43(36.75) | 0.358 | 0.78[0.45–1.33] |
| Liver disease [n, %] | 17(14.29) | 14(11.97) | 0.597 | 1.23[0.57–2.62] |
| Pregnancy [n, %] | 1(0.84) | 0(0) | 1.00 | ND |
| Postpartum [n, %] | 2(1.69) | 0(0) | 0.497 | ND |
| Imunodeficiency [n, %] | 3(2.52) | 2(1.71) | 1.00 | 1.49[0.24–9.06] |
| Autoimune disease [n, %] | 8(6.72) | 10(8.55) | 0.597 | 0.77[0.29–2.03] |
| Obesity [n, %] | 38(31.93) | 48(41.03) | 0.146 | 0.67[0.39–1.15] |
| Overweight [n, %] | 30(25.21) | 30(25.64) | 0.939 | 0.98[0.54–1,76] |
| Oncological disease [n, %] | 16(13.45) | 9(7.69) | 0.151 | 1.86[0.79–4.41] |
| Psychiatric patology [n, %] | 7(5.88) | 1(0.85) | 0.065 | 7.25[0.87–59.88] |
| Urinary catheterization [n, %] | 119(100) | 117(100) | / | / |
| CVC [n, %] | 108(90.76) | 91(77.78) | 0.006 | 2.80[1.31–5.98] |
| Peripheral venous catheterization [n, %] | 49(41.18) | 68(58.12) | 0.009 | 0.50[0.30–0.85] |
| Diaysis [n, %] | 18(15.13) | 14(11.97) | 0.478 | 1.31[0.62–2.78] |
| Gastrostomy [n, %] | 1(0.84) | 0(0) | 1.00 | ND |
| Enteral Nutrition [n, %] | 114(95.80) | 107(91.45) | 0.171 | 2.13[0.71–6.44] |
| Tracheostomy [n, %] | 2(1.68) | 1(0.85) | 1.00 | 0.98[0.14–7.09] |
| Unfavorable outcome* [n, %] | 89(74.78) | 90(76.92) | 0.701 | 0.89[0.49–1.62] |
| No antibiotics [n, %] | 3(2.52) | 13(11.11) | 0.009 | 0.21[0.06–0.075] |
| 1 antibiotic [n, %] | 25(21.01) | 55(47.01) | <0.001 | 0.29[0.17–0.53] |
| 2 antibiotics [n, %] | 26(21.85) | 30(25.64) | 0.493 | 0.81[0.44–1.48] |
| 3 antibiotics [n, %] | 38(31.93) | 13(11.11) | <0.001 | 3.75[1.87–7.51] |
| 4 antibiotics [n, %] | 17(14.29) | 3(2.56) | 0.001 | 6.33[1.80–22.24] |
Notes: *Unfavorable outcome = deceased + aggravated (We considered a patient aggravated if one of the following occurred: escalating the form of respiratory support from non-invasive ventilation to invasive mechanical ventilation, development of a new organ failure, development of septic shock and increased need for vasoactive drugs).
Abbreviations: n, number; CVC, central venous catheter; ARDS, acute respiratory distress syndrome; ALT, alanine transaminase; AST, aspartate aminotransferase; CRP, C reactive protein; BMI, body mass index; WBC, white blood cells; ND, not defined.