Evidence map›Paper›PMID 34100002›Full record

ArticleThe Lancet. Microbe2021

Co-infections, secondary infections, and antimicrobial use in patients hospitalised with COVID-19 during the first pandemic wave from the ISARIC WHO CCP-UK study: a multicentre, prospective cohort study.

Clark D Russell, Cameron J Fairfield, Thomas M Drake, Lance Turtle, R Andrew Seaton, Dan G Wootton, Louise Sigfrid, Ewen M Harrison, Annemarie B Docherty, Thushan I de Silva and 12 more

Open access · goldAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in The Lancet. Microbe, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 211 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
211citing papers in PubMed, 4 pooled it
38.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

211 citing papers in PubMed, 4 syntheses or guidelines pooled it, 332 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Antibiotics for the treatment of COVID-19.The Cochrane database of systematic reviews · 2021
    Pooled it
  5. Trial
  6. Article
  7. Article
  8. Review
  9. Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Review
  18. Article
  19. Article
  20. Review

151 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

22 authors at 11 institutions in 1 country.

Clark D RussellUniversity of Edinburgh Centre for Inflammation Research, Edinburgh, UK; Roslin Institute, University of Edinburgh, Easter Bush, Edinburgh, UK.
Cameron J FairfieldCentre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, UK.
Thomas M DrakeCentre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, UK.
Lance TurtleInstitute of Infection, Veterinary and Ecological Sciences, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK; Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK.
R Andrew SeatonDepartment of Infectious Diseases, Queen Elizabeth University Hospital, Glasgow, UK.
Dan G WoottonInstitute of Infection, Veterinary and Ecological Sciences, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK; Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK.
Louise SigfridISARIC Global Support Centre, Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
Ewen M HarrisonCentre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, UK.
Annemarie B DochertyCentre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, UK.
Thushan I de SilvaSouth Yorkshire Regional Department of Infection and Tropical Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK; Department of Infection, Immunity and Cardiovascular Disease, Medical School, University of Sheffield, UK.
Conor EganCentre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, UK.
Riinu PiusCentre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, UK.
Hayley E HardwickInstitute of Infection, Veterinary and Ecological Sciences, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK.
Laura MersonISARIC Global Support Centre, Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
Michelle GirvanLiverpool Clinical Trials Centre, University of Liverpool, Liverpool, UK.
Jake DunningEmerging Infections and Zoonoses Unit, National Infection Service, Public Health England, Colindale, London, UK.
Jonathan S Nguyen-Van-TamDivision of Epidemiology and Public Health, University of Nottingham School of Medicine, Nottingham, UK; UK Department of Health and Social Care, London, UK.
Peter J M OpenshawNational Heart and Lung Institute, Imperial College London, London, UK.
J Kenneth BaillieRoslin Institute, University of Edinburgh, Easter Bush, Edinburgh, UK.
Malcolm G SempleInstitute of Infection, Veterinary and Ecological Sciences, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK; Department of Respiratory Medicine, Alder Hey Children's Hospital, Liverpool, UK.
Antonia HoMedical Research Council-University of Glasgow Centre for Virus Research, University of Glasgow, Glasgow, UK. Electronic address: antonia.ho@glasgow.ac.uk.
ISARIC4C investigators
University of Liverpool · GBRoslin Institute · GBUniversity of Edinburgh · GBQueen Elizabeth University Hospital · GBUniversity of Oxford · GBImperial College London · GBDepartment of Health and Social Care · GBSheffield Teaching Hospitals NHS Foundation Trust · GBPublic Health England · GBMRC University of Glasgow Centre for Virus Research · GBCentre for Inflammation Research · GB

Funding

Medical Research Council G0701652Medical Research Council MC_PC_15001Medical Research Council MC_PC_19025Medical Research Council MC_PC_19026Medical Research Council MC_PC_19059Medical Research Council MC_UU_12014/10Medical Research Council MC_UU_12014/12Medical Research Council MC_UU_12014/8Medical Research Council MC_UU_12014/9Medical Research Council MR/S032304/1Wellcome Trust 109965/Z/15/ZWellcome Trust 205228/Z/16/ZWellcome Trust 215091/Z/18/Z
6 · The paper itself

Abstract

backgroundMicrobiological characterisation of co-infections and secondary infections in patients with COVID-19 is lacking, and antimicrobial use is high. We aimed to describe microbiologically confirmed co-infections and secondary infections, and antimicrobial use, in patients admitted to hospital with COVID-19.

methodsThe International Severe Acute Respiratory and Emerging Infections Consortium (ISARIC) WHO Clinical Characterisation Protocol UK (CCP-UK) study is an ongoing, prospective cohort study recruiting inpatients from 260 hospitals in England, Scotland, and Wales, conducted by the ISARIC Coronavirus Clinical Characterisation Consortium. Patients with a confirmed or clinician-defined high likelihood of SARS-CoV-2 infection were eligible for inclusion in the ISARIC WHO CCP-UK study. For this specific study, we excluded patients with a recorded negative SARS-CoV-2 test result and those without a recorded outcome at 28 days after admission. Demographic, clinical, laboratory, therapeutic, and outcome data were collected using a prespecified case report form. Organisms considered clinically insignificant were excluded.

findingsWe analysed data from 48 902 patients admitted to hospital between Feb 6 and June 8, 2020. The median patient age was 74 years (IQR 59-84) and 20 786 (42·6%) of 48 765 patients were female. Microbiological investigations were recorded for 8649 (17·7%) of 48 902 patients, with clinically significant COVID-19-related respiratory or bloodstream culture results recorded for 1107 patients. 762 (70·6%) of 1080 infections were secondary, occurring more than 2 days after hospital admission.

interpretationIn patients admitted to hospital with COVID-19, microbiologically confirmed bacterial infections are rare, and more likely to be secondary infections. Gram-negative organisms and

fundingNational Institute for Health Research (NIHR), UK Medical Research Council, Wellcome Trust, UK Department for International Development, Bill & Melinda Gates Foundation, EU Platform for European Preparedness Against (Re-)emerging Epidemics, NIHR Health Protection Research Unit (HPRU) in Emerging and Zoonotic Infections at University of Liverpool, and NIHR HPRU in Respiratory Infections at Imperial College London.

Indexed as

Anti-Infective AgentsCoinfectionCOVID-19Respiratory Tract InfectionsAgedAged, 80 and overFemaleHumansMaleMiddle AgedPandemicsProspective StudiesSARS-CoV-2United KingdomWorld Health OrganizationAnti-Infective Agents

Identifiers

PMID34100002
PMCPMC8172149
OpenAlexW3172366125

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.