ArticleDiagnostics (Basel, Switzerland)2022
Co-Infections and Superinfections in COVID-19 Critically Ill Patients Are Associated with CT Imaging Abnormalities and the Worst Outcomes.
Article in Diagnostics (Basel, Switzerland), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
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Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Guideline
- Patient Safety Implications of Opportunistic Pathogens and Healthcare-Associated Infections in COVID-19 Patients: A Narrative Review.Healthcare (Basel, Switzerland) · 2026Review
- Association of nasopharyngealMicrobiology spectrum · 2026Article
- Diagnosis, clinical features and survival analysis of invasive pulmonary aspergillosis among critically ill patients: a retrospective cohort study based on updated criteria.Frontiers in cellular and infection microbiology · 2026Article
- Comprehensive review of pulmonary embolism imaging: past, present and future innovations in computed tomography (CT) and other diagnostic techniques.Japanese journal of radiology · 2025Review
- Incidence and Risk Factors of Secondary Infections in Critically Ill SARS-CoV-2 Patients: A Retrospective Study in an Intensive Care Unit.Biomedicines · 2025Article
- The Antimicrobial Efficacy of Copper Complexes: A Review.Antibiotics (Basel, Switzerland) · 2025Review
- Invasive Candidiasis Coinfection in Patients with Severe COVID-19 Disease: Scoping Review.Pathogens (Basel, Switzerland) · 2025Article
- Epidemiology, Ventilation Management, and Outcomes in Invasively Ventilated Coronavirus Disease 2019 Patients: An Analysis of Four Observational Studies in Four Countries on Two Continents.The American journal of tropical medicine and hygiene · 2025Observational
- Clinical and pathogen features of COVID-19-associated infections during an Omicron strain outbreak in Guangzhou, China.Microbiology spectrum · 2024Article
- Predicting early appropriate therapy for patients infected by carbapenem-resistant Gram-negative pathogens in intensive care units in Italy.Antimicrobial resistance and infection control · 2024Article
- Prevalence and risk factors of cytomegalovirus reactivation in critically Ill patients with COVID-19 pneumonia.PloS one · 2024Article
- Comparison of Computed Tomography and Clinical Features Between Patients Infected with the SARS-CoV-2 Omicron Variant and the Original Strain.Infection and drug resistance · 2024Article
- A dynamic nomogram to predict invasive fungal super-infection during healthcare-associated bacterial infection in intensive care unit patients: an ambispective cohort study in China.Frontiers in cellular and infection microbiology · 2024Article
- Review
- Long COVID Complicated by Fatal Cytomegalovirus and Aspergillus Infection of the Lungs: An Autopsy Case Report.Viruses · 2023Article
- Pulmonary Co-Infections Detected Premortem Underestimate Postmortem Findings in a COVID-19 Autopsy Case Series.Pathogens (Basel, Switzerland) · 2023Article
- Fungal-Bacterial Co-Infections and Super-Infections among Hospitalized COVID-19 Patients: A Systematic Review.Journal of fungi (Basel, Switzerland) · 2023Review
- Leading Pathogens Involved in Co-Infection and Super-Infection with COVID-19: Forensic Medicine Considerations after a Systematic Review and Meta-Analysis.Pathogens (Basel, Switzerland) · 2023Review
- Differences in clinical characteristics and quantitative lung CT features between vaccinated and not vaccinated hospitalized COVID-19 patients in Italy.Annals of intensive care · 2023Article
Corrections and comments
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Authors and funding
11 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Bacterial and fungal co-infections and superinfections have a critical role in the outcome of the COVID-19 patients admitted to the Intensive Care Unit (ICU). Methods: The present study is a retrospective analysis of 95 patients admitted to the ICU for COVID-19-related ARDS during the first (February−May 2020) and second waves of the pandemic (October 2020−January 2021). Demographic and clinical data, CT imaging features, and pulmonary and extra-pulmonary complications were recorded, as well as the temporal evolution of CT findings when more than one scan was available. The presence of co-infections and superinfections was registered, reporting the culprit pathogens and the specimen type for culture. A comparison between patients with and without bacterial and/or co-infections/superinfections was performed. Results: Sixty-three patients (66.3%) developed at least one confirmed co-infection/superinfection, with 52 (82.5%) developing pneumonia and 43 (68.3%) bloodstream infection. Gram-negative bacteria were the most common co-pathogens identified and Aspergillus spp. was the most frequent pulmonary microorganism. Consolidations, cavitations, and bronchiectasis were significantly associated with the presence of co-infections/superinfections (p = 0.009, p = 0.010 and p = 0.009, respectively); when considering only patients with pulmonary co-pathogens, only consolidations remained statistically significative (p = 0.004). Invasive pulmonary aspergillosis was significantly associated with the presence of cavitations and bronchiectasis (p < 0.001). Patients with co-infections/superinfections presented a significantly higher mortality rate compared to patients with COVID-19 only (52.4% vs. 25%, p = 0.016). Conclusions: Bacterial and fungal co-infections and superinfections are frequent in COVID-19 patients admitted to ICU and are associated with worse outcomes. Imaging plays an important role in monitoring critically ill COVID-19 patients and may help detect these complications, suggesting further laboratory investigations.
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