Risk Factors of Severe COVID-19: A Review of Host, Viral and Environmental Factors

Viruses, Journal Year: 2023, Volume and Issue: 15(1), P. 175 - 175

Published: Jan. 7, 2023

The clinical course and outcome of COVID-19 are highly variable, ranging from asymptomatic infections to severe disease death. Understanding the risk factors is relevant both in setting at epidemiological level. Here, we provide an overview host, viral environmental that have been shown or (in some cases) hypothesized be associated with outcomes. considered detail include age frailty, genetic polymorphisms, biological sex (and pregnancy), co- superinfections, non-communicable comorbidities, immunological history, microbiota, lifestyle patient; variation infecting dose; socioeconomic factors; air pollution. For each category, compile (sometimes conflicting) evidence for association factor outcomes (including strength effect) outline possible action mechanisms. We also discuss complex interactions between various factors.

Language: Английский

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A meta-meta-analysis of co-infection, secondary infections, and antimicrobial resistance in COVID-19 patients

Journal of Infection and Public Health, Journal Year: 2023, Volume and Issue: 16(10), P. 1562 - 1590

Published: July 18, 2023

The newly discovered coronavirus SARS-CoV-2 has sparked a worldwide pandemic of COVID-19, which caused havoc on medical infrastructures, economies, and cultures around the world. Determining whole scenario is essential since variants sub-variants keep appearing after vaccinations booster doses. objective this secondary meta-analysis to analysis co-infection, infections, antimicrobial resistance (AMR) in COVID-19 patients. This study used five significant databases conduct systematic review an overlap evaluate pooled estimates co-infections infections. summary showed overall co-infection effect 26.19% (95% confidence intervals CI: 21.39 31.01, I2=98.78, n = 14 meta-analysis) among patients with COVID-19. A coinfection 11.13% 9.7 12.56, I2=99.14, 11 for bacteria; 9.69% 1.21 7.90, I2 =98.33) fungal 3.48% 2.15 4.81, =95.84) viruses. infection 19.03% 9.53 28.54, =85.65) was from 2 meta-analyses (Ave: 82 primary studies). first that compiles results all previous three years into single source offers strong proof infections Early detection AMR crucial order effectively effective treatment.

Language: Английский

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Incidence and clinical outcomes of bacterial superinfections in critically ill patients with COVID-19

Frontiers in Medicine, Journal Year: 2023, Volume and Issue: 10

Published: March 2, 2023

Bacterial superinfection is not uncommon in critically ill patients with coronavirus disease (COVID-19) pneumonia requiring intensive care unit (ICU) treatment. However, there still a lack of evidence related to bacterial and their clinical significance COVID-19. Therefore, we assessed the incidence superinfections effects on outcomes COVID-19.This single-center retrospective cohort study analyzed COVID-19 admitted ICU at tertiary academic hospital between February 2020 December 2021. We reviewed data including patient demographics, microbiological characteristics, outcomes.During period, 106 (median [IQR] age, 67 [58-75] years) were included, which 32 (30%) diagnosed superinfections. Of these, 12 cases (38%) associated multidrug-resistant pathogens. Klebsiella aerogenes (6 [19%]) pneumoniae most common pathogens The median time was 13 (IQR, 9-20) days after admission. Patients had significantly fewer ventilator-free day 28 (0 [IQR, 0-0] days) than those without (19 0-22] (p < 0.001). longer length stay (32 9-53] (11 7-18] Additionally, they admission (39 18-62] (18 12-37] = There no differences mortality or in-hospital two groups. In multivariable analysis, higher SAPS II score (OR, 2.697; 95% CI, 1.086-6.695) thrombocytopenia 3.318; 1.355-8.123) identified as risk factors for development superinfection.In COVID-19, common, more one-third caused by As worse outcomes, should be actively monitored.

Language: Английский

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Bacterial and fungal superinfections are detected at higher frequency in critically ill patients affected by SARS CoV‐2 infection than negative patients and are associated to a worse outcome

Journal of Medical Virology, Journal Year: 2023, Volume and Issue: 95(7)

Published: July 1, 2023

Abstract Patients with viral infections are at higher risk to acquire bacterial and fungal superinfections associated a worse prognosis. We explored this critical point in the setting of patients severe COVID‐19 disease. The study included 1911 admitted intensive care unit (ICU) during 2‐year period (March 2020–March 2022). Of them, 713 (37.3%) were infected SARS‐CoV‐2 1198 negative (62.7%). Regression analysis was performed determine factors presence and/or evaluate predictors ICU mortality. infection, 473 (66.3%) had respiratory bloodstream superinfections, while COVID‐19‐negative patients, only 369 (30%) showed ( p < 0.0001). Baseline characteristics median age 66 (interquartile range [IQR], 58–73), predominance males (72.7%), BMI than 24 (median 26; IQR, 24.5–30.4). Seventy‐four percent (527, 73.9%) one or more comorbidities 135 (18.9%) them received previous antibiotic therapy. Furthermore, most (473, 66.3%) exhibited radiological pictures needed invasive mechanical ventilation. Multivariate logistic regression that 1 increment rises acquisition by 3% 1‐day stays 11%. ventilation superinfection 2.7 times. both significantly mortality rate without (45.8% vs. 26.2%, Therefore, frequent their is outcome. This an important consideration for targeted therapies critically ill improve clinical course.

Language: Английский

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SARS-CoV-2 suppresses TLR4-induced immunity by dendritic cells via C-type lectin receptor DC-SIGN

PLoS Pathogens, Journal Year: 2023, Volume and Issue: 19(10), P. e1011735 - e1011735

Published: Oct. 16, 2023

SARS-CoV-2 causes COVID-19, an infectious disease with symptoms ranging from a mild cold to severe pneumonia, inflammation, and even death. Although strong inflammatory responses are major factor in causing morbidity mortality, superinfections bacteria during COVID-19 often cause bacteremia sepsis. Aberrant immune might underlie increased sensitivity but the mechanisms remain unclear. Here we investigated whether directly suppresses bacteria. We studied functionality of human dendritic cells (DCs) towards variety bacterial triggers after exposure Spike (S) protein primary isolate (hCoV-19/Italy). Notably, pre-exposure DCs either S or led reduced type I interferon (IFN) cytokine response Toll-like receptor (TLR)4 agonist lipopolysaccharide (LPS), whereas other TLR agonists were not affected. interacted C-type lectin DC-SIGN and, notably, blocking antibodies restored IFN LPS. Moreover, kinase Raf-1 by small molecule inhibitor These results suggest that modulates DC function upon TLR4 triggering via DC-SIGN-induced pathway. data imply actively DC-SIGN, which account for higher mortality rates observed patients superinfections.

Language: Английский

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Poor Prognosis of Pneumococcal Co-Infection in Hospitalized Patients with COVID-19: A Propensity Score-Matched Analysis

Infection and Chemotherapy, Journal Year: 2025, Volume and Issue: 57

Published: Jan. 1, 2025

The impact of Streptococcus pneumoniae coinfection on coronavirus disease 2019 (COVID-19) prognosis remains uncertain. We conducted a retrospective analysis patients hospitalized with COVID-19 who underwent pneumococcal urinary antigen (PUA) test to assess its clinical utility. Results showed that PUA-positive required more oxygen support, high-flow nasal cannula, and dexamethasone compared PUA-negative patients. Furthermore, the significantly higher incidence National Early Warning Score ≥5 in group (P<0.001) suggests positive PUA is associated severe course. However, no significant difference mortality was observed between two groups, antibiotics were used almost all (96.2%). While may help guide antibiotic use patients, interpretation should be approached caution.

Language: Английский

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Kinetic Patterns of Antibiotic Consumption in German Acute Care Hospitals from 2017 to 2023

Antibiotics, Journal Year: 2025, Volume and Issue: 14(3), P. 316 - 316

Published: March 18, 2025

Background: Antimicrobial consumption (AMC) patterns, besides prescribing behaviors, reflect the changing epidemiology of infectious diseases. Routine surveillance data have been used to investigate development AMC from 2017 2023 and impact COVID-19 within context framing time periods. Methods: Data 112 hospitals, continuously participating in national system hospital antimicrobial based at Robert Koch Institute, were analyzed according WHO ATC (Anatomical Therapeutic Chemical)/DDD (Defined Daily Dose) method categorized AWaRe-classification. was quantified by density (CD) expressed DDD/100 patient days (PD) admissions (AD). The period subdivided into three phases: pre-pandemic phase (2017–2019), main pandemic (2020–2021) transition (2022–2023). Linear regression models determine presence an overall trend, change intra-phasic trends phase-specific mean levels over time. Results: From total antibiotic decreased 7% 57.1 52.9 PD. Four kinetic patterns emerged across different classes: Pattern 1 displays a decreasing which slowed down throughout exhibited second-generation cephalosporins fluoroquinolones. 2 reveals rising decelerated accelerated again aminopenicillins/beta-lactamase inhibitors, beta-lactamase sensitive pencillins, azithromycin first-generation cephalosporins. 3 shows elevated carbapenems, glycopeptides, linezolid third-generation 4 trend phase, reversed without achieving resistant penicillins, daptomycin, fosfomycin (parenteral) ceftazidime/avibactam. Conclusions: Kinetic classes might COVID-19-related effects associated changes co-circulating pathogens health care supply. Broad-spectrum antibiotics with persisting require special attention focused stewardship activities.

Language: Английский

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Prevalence of SARS-COV-2 and other respiratory pathogens among a Jordanian subpopulation during Delta-to-Omicron transition: Winter 2021/2022

PLoS ONE, Journal Year: 2023, Volume and Issue: 18(3), P. e0283804 - e0283804

Published: March 30, 2023

Acute respiratory tract infections (ARTIs) during the winter months are associated with higher morbidity and mortality compared to other seasons of year, children below five, elderly, immunocompromised patients being most susceptible. Influenza A B viruses, rhinovirus, coronaviruses, syncytial virus, adenovirus, parainfluenza frequently identified causes viral ARTIs. In addition, emergence SARS-CoV-2 in 2019 provided an additional cause The aim this study was provide overview epidemiological status upper infections, their main causative agents, reported clinical presentation 2021, two important surges COVID-19 Jordan. Nasopharyngeal samples were collected from 339 symptomatic period December 2021 March 2022, followed by nucleic acid isolation using a Viral RNA/DNA extraction Kit. virus species patient’s symptoms determined utilizing multiplex real-time PCR targeting 21 11 bacteria, single fungus. 39.2% (n = 133/339). total 15 different pathogens also as co-infections among these 133 67/133). SARS-CoV-2-Bacterial coinfections (37.6%, n 50/133) frequent, Bordetella common, Staphylococcus aureus , H . influenzae type coinfection rate 27.8% 37/133), Human bocavirus common. Conclusion, Both SARS-CoV-2, influenza accounted for majority URTI 2021–2022. Interestingly, more than 50% URTIs confirmed have or pathogens, predominant.

Language: Английский

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A beacon in the dark: COVID-19 course in CVID patients from two European countries: Different approaches, similar outcomes

Frontiers in Immunology, Journal Year: 2023, Volume and Issue: 14

Published: Feb. 8, 2023

Background CVID patients present an increased risk of prolonged SARS-CoV-2 infection and re-infection a higher COVID-19-related morbidity mortality compared to the general population. Since 2021, different therapeutic prophylactic strategies have been employed in vulnerable groups (vaccination, monoclonal antibodies antivirals). The impact treatments over last 2 years has not explored international studies considering emergence viral variants management between countries. Methods A multicenter retrospective/prospective real-life study comparing prevalence outcomes cohort from four Italian Centers (IT-C) one Netherlands (NL-C), recruiting 773 patients. Results 329 were found positive for March 1 st , 2020 September 2022. proportion infected was comparable both national sub-cohorts. During all waves, chronic lung disease, “complicated” phenotype, immunosuppressive treatment cardiovascular comorbidities impacted on hospitalization, whereas factors older age, bacterial superinfections. IT-C significantly more often treated, with antivirals mAbs, than NL-C Outpatient treatment, available only Italy, started Delta wave. Despite this, no significant difference COVID-19 severity two cohorts. However, pooling together specific outpatient (mAbs antivirals), we effect hospitalization starting Vaccination ≥ 3 doses shortened RT-PCR positivity, additional receiving antivirals. Conclusions sub-cohorts had similar despite approaches. This points out that should now be reserved selected subgroups patients, based pre-existing conditions.

Language: Английский

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Early Bacterial Coinfections in Patients Admitted to the ICU With COVID-19 or Influenza: A Retrospective Cohort Study

Critical Care Explorations, Journal Year: 2023, Volume and Issue: 5(4), P. e0895 - e0895

Published: April 1, 2023

IMPORTANCE: Previous findings suggest that bacterial coinfections are less common in ICU patients with COVID-19 than influenza, but evidence is limited. OBJECTIVES: This study aimed to compare the rate of early or influenza. DESIGN, SETTING AND PARTICIPANTS: Retrospective propensity score matched cohort study. We included admitted ICUs a single academic center influenza (January 2015 April 2022). MAIN OUTCOMES MEASURES: The primary outcome was coinfection (i.e., positive blood respiratory culture within 2 d admission) cohort. Key secondary outcomes frequency microbiological testing, antibiotic use, and 30-day all-cause mortality. RESULTS: Out 289 39 117 ( n = 78 vs 39) were analysis. In cohort, similar between (18/78 [23%] 8/39 [21%]; odds ratio, 1.16; 95% CI, 0.42–3.45; p 0.82). testing use two groups. Within overall group, associated statistically significant increase mortality (21/68 [30.9%] 40/221 [18.1%]; hazard 1.84; 1.01–3.32). CONCLUSIONS RELEVANCE: Our data rates addition, significantly an increased COVID-19.

Language: Английский

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