Table 1.
Baseline characteristics of patients and type of superinfections
| Variable | Total population N = 201 |
Non infection group N = 155 |
Infection group N = 46 |
p value |
|---|---|---|---|---|
| Age, median (IQR), years | 67 (56–80) | 66 (55–77) | 77 (65–83) | 0.0005 |
| Sex (M), n (%) | 127 (63) | 100 (64) | 27 (58%) | 0.49 |
| Demographics | ||||
| Autoimmune disease, n (%) | 3 (1.4) | 2 (1.2) | 1 (2.1) | 0.54 |
| Chronic steroid/immunosuppressive therapy, n (%) | 17 (8.4) | 9 (5.8) | 8 (17.3) | 0.029 |
| Diabetes, n (%) | 45 (22) | 29 (18.7) | 16 (34.7) | 0.027 |
| Chronic ischemic heart disease, n (%) | 43 (21) | 24 (15.4) | 19 (41.3) | 0.0004 |
| Hypertension, n (%) | 93 (46) | 67 (43.2) | 26 (56.5) | 0.13 |
| Heart failure, n (%) | 21 (10.4) | 8 (5.1) | 13 (28.2) | 0.0001 |
| Atrial fibrillation, n (%) | 24 (11.9) | 14 (9) | 10 (21.7) | 0.034 |
| Vasculopathy, n (%) | 19 (9.4) | 15 (9.6) | 4 (8.6) | 0.99 |
| Cerebrovascular disease, n (%) | 12 (5.9) | 7 (4.5) | 5 (10.8) | 0.15 |
| Dementia, n (%) | 15 (7.4) | 9 (5.8) | 6 (13) | 0.10 |
| COPD, n (%) | 30 (14.9) | 22 (14.1) | 8 (17.3) | 0.63 |
| Chronic hepatopathy, n (%) | 9 (4.4) | 5 (3.2) | 4 (8.6) | 0.21 |
| Solid malignancy, n (%) | 17 (8.4) | 9 (5.8) | 8 (17.3) | 0.029 |
| Hematological malignancy, n (%) | 7 (3.4) | 5 (3.2) | 2 (4.3) | 0.66 |
| Chronic kidney disease, n (%) | 13 (6.4) | 7 (4.5) | 4 (8.6) | 0.27 |
| Obesity (BMI > 30), n (%) | 31 (15.4) | 26 (16.7) | 5 (10.8) | 0.48 |
| Charlson Comorbidity Index, median (IQR) | 3 (2–5) | 3 (1–4) | 5 (3.25–6) | 0.0001 |
| Prior (30-d) infections*, n (%) | 13 (6.4) | 4 (2.5) | 9 (19.5) | 0.0003 |
| Prior (30-d) chemotherapy, n (%) | 2 (0.9) | 1 (0.6) | 1(2.1) | 0.4 |
| Prior (30-d) hospitalization, n(%) | 27 (13.4) | 17 (10.9) | 10 (21.7) | 0.24 |
| Central line catheter, n (%) | 12 (5.9) | 3 (1.9) | 9 (19.5) | 0.0001 |
| Total parental nutrition, n (%) | 12 (5.9) | 3 (1.9) | 9 (19.5) | 0.0001 |
| Severe COVID-19**, n (%) | 106 (52.7) | 76 (49) | 30 (66) | 0.06 |
| First PaO2/FiO2 ratio at ED admission, median (IQR) | 300 (248–333) | 305 (252–338) | 271 (213–320) | 0.06 |
| Transferred from ICU, n (%) | 2 (0.9) | 1 (0.6) | 1(2.1) | 0.4 |
| Symptoms at COVID onset, n (%) | ||||
| Fever | 143 (59) | 112 (72) | 31 (67.3) | 0.57 |
| Cough | 66 (32) | 59 (38) | 7 (15.2) | 0.039 |
| Dyspnea | 114 (56) | 86 (55.4) | 28 (60.8) | 0.6 |
| Laboratory parameters at admission | ||||
| Leucocytes (× 103/mm3), median (IQR) | 7050 (4905–10,590) | 7110 (5120–10,150) | 6900 (4570–11,410) | 0.9 |
| Neutrophils (× 103/mm3), median (IQR) | 5585 (3660–8990) | 5580 (3660–8640) | 5610 (3690–9640) | 0.79 |
| Lymphocyte (× 103/mm3), median (IQR) | 760 (532,5–1020) | 760 (540–1040) | 690 (490–990) | 0.49 |
| Platelet (× 103/mm3), median (IQR) | 195 (156.25–256.75) | 196 (1257–256) | 190 (151–270) | 0.98 |
| Creatinine, median (IQR) mg/dl | 1 (0.8–1.2) | 0.9 (0.8–1.1) | 1.1 (0.9–1.4) | 0.075 |
| Albuminemia, median (IQR) g/dl | 3.7 (3.5–4) | 3.7(3.5–4) | 3.7 (3.1–3,9) | 0.9 |
| D-Dimer, median (IQR) U/l | 760 (473.2–1369.75) | 665.5 (431–1102) | 1281 (756–2335) | 0.0001 |
| CRP, median (IQR) mg/dl | 5.4 (1.7–10) | 5.5 (2–10.3) | 5.7 (1.2–10.4) | 0.65 |
| MDR colonization, n (%) | 23 (11) | 5 (3.2) | 18 (39) | 0.0001 |
| Long of in-hospital stay, median (IQR), days | 18 (12–26) | 16 (11–22) | 30 (19–45) | 0.001 |
| Prior antibiotic therapy (30-d), n (%) | 162 (80.5) | 116 (74) | 46 (100) | 0.0001 |
| Transfer to ICU | 12 (5.9) | 5 (3.2) | 7 (15.2) | 0.068 |
| Corticosteroid therapy, n (%) | 195 (97) | 149 (96.1) | 46 (100) | 0.33 |
| Mortality, n (%) | 61 (30.3) | 35 (22) | 26 (56) | 0.0001 |
| Pronation, n (%) | 17 (8.5) | 15 (9.7) | 2 (4.3) | 0.254 |
| Sedation, n (%) | 16 (8) | 10 (6.4) | 6 (13) | 0.155 |
| Respiratory failure treatment, n (%) | 0.008 | |||
| HFNC | 25 (12.4) | 19 (12.2) | 6 (13) | |
| Venturi mask | 51 (25.4) | 41 (26.4) | 10 (21.7) | |
| Helmet CPAP | 104 (51.7) | 85 (54.8) | 19 (41.3) | |
| NIMV | 21 (10.4) | 10 (6.4) | 11 (23.9) | |
| Superinfections episodes°, n (%) | 64 (100) | NA | 64 (100) | NA |
| Type of superinfections episodes, n (%) | ||||
| Primary bloodstream infection | 23 (35.9) | NA | 23 (35.9) | NA |
| Hospital-acquired pneumonia | 19 (29.6) | NA | 19 (29.6) | NA |
| Urinary infections | 18 (28.5) | NA | 18 (28.5) | NA |
| CR-BSI | 2 (3.1) | NA | 2 (3.1) | NA |
| Skin and soft tissues infections | 1 (1.5) | NA | 1 (1.5) | NA |
| Clostridoides difficile colitis | 1 (1.5) | NA | 1 (1.5) | NA |
Bold is used to emphasize relevant p values
COPD: chronic obstructive pulmonary disease; ED: Emergency department; CRP: C-reactive protein; MDR: multi-drug resistant; ICU: intensive care unit; CR-BSI: catheter-related bloodstream infection. NA: not applicable. 30-d: 30 days before infection development
*Prior (30-d) infections referred to infections diagnosed within 30 days before hospital admission
**Severe COVID-19 was defined according to WHO definitions [17]
°Superinfections episodes: the total number is different because several patients experienced > 1 infective episode (46 patients for a total of 64 episodes). HFNC: High Flow Nasal Cannula; CPAP: Continuous Positive Airway Pressure; NIMV: Non-invasive mechanical ventilation