Predictors of bacteremia and death, including immune status, in a large single-center cohort of unvaccinated ICU patients with COVID-19 pneumonia

European Journal of Medical Research

Research

Ennio Polilli¹  Fabrizio Carinci²  Stefano Ianniruberto³  Giustino Parruti³  Giorgia Rapacchiale³  Elena Mazzotta³  Simona Coladonato³  Vincenzo Savini⁴  Antonella Spacone⁵  Antonella Frattari⁶  Angelo Moretta⁶  Lina Visocchi⁶  Rosamaria Zocaro⁶  Alessandro Patarchi⁶  Mariangela Battilana⁶  Raffaella Ciulli⁶ 

[1] Clinical Pathology Unit, Pescara General Hospital, Pescara, Italy;Department of Statistical Sciences, Università Di Bologna, Bologna, Italy;Infectious Diseases Unit, Pescara General Hospital, Pescara, Italy;Microbiology and Virology Unit, Pescara General Hospital, Pescara, Italy;Pneumology Unit, Pescara General Hospital, Pescara, Italy;Unit of Intensive Care, Pescara General Hospital, Pescara, Italy;

关键词: Lymphocytopenia;    Colonization;    Herpesviridae;    COVID-19;    Bacteremia;    ICU;    Mortality;   

DOI  :  10.1186/s40001-023-01166-8

 received in 2022-08-26, accepted in 2023-06-11,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundWe investigated the possible role of the immune profile at ICU admission, among other well characterized clinical and laboratory predictors of unfavorable outcome in COVID-19 patients assisted in ICU.MethodsRetrospective analysis of clinical and laboratory data collected for all consecutive patients admitted to the ICUs of the General Hospital of Pescara (Abruzzo, Italy), between 1st March 2020 and 30th April 2021, with a confirmed diagnosis of COVID-19 respiratory failure. Logistic regressions were used to identify independent predictors of bacteremia and mortality.ResultsOut of 431 patients included in the study, bacteremia was present in N = 191 (44.3%) and death occurred in N = 210 (48.7%). After multivariate analysis, increased risk of bacteremia was found for viral reactivation (OR = 3.28; 95% CI:1.83–6.08), pronation (3.36; 2.12–5.37) and orotracheal intubation (2.51; 1.58–4.02). Increased mortality was found for bacteremia (2.05; 1.31–3.22), viral reactivation (2.29; 1.29–4.19) and lymphocytes < 0.6 × 103c/µL (2.32; 1.49–3.64).ConclusionsWe found that viral reactivation, mostly due to Herpesviridae, was associated with increased risk of both bacteremia and mortality. In addition, pronation and intubation are strong predictors of bacteremia, which in turn together with severe lymphocytopenia due to SARS-CoV2 was associated with increased mortality. Most episodes of bacteremia, even due to Acinetobacter spp, were not predicted by microbiological evidence of colonization.

【 授权许可】

CC BY   
© The Author(s) 2023