ArticleBMC pulmonary medicine2023
Impact of respiratory bacterial infections on mortality in Japanese patients with COVID-19: a retrospective cohort study.
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Article in BMC pulmonary medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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11citing papers in PubMed
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Who cites it
11 citing papers in PubMed, 15 citations in OpenAlex.
- Consolidation-to-ground-glass opacity ratio on chest CT as a prognostic marker for critical outcomes in COVID-19: a retrospective cohort study.BMC pulmonary medicine · 2025Article
- Baseline predictors of antibiotics de-escalation from empirical therapies in an intensive care unit: a five-year retrospective study.BMC infectious diseases · 2025Article
- The COVID-19 pandemic: an underlying factor for increasedFrontiers in microbiology · 2025Review
- Severe co-infection caused by difficult-to-diagnose hypermucoviscous Klebsiella pneumoniae K1-ST82 in a patient with COVID-19: a case report.BMC infectious diseases · 2024Article
- A Case of COVID-19 and Methicillin-Resistant Staphylococcus aureus (MRSA) Coinfection Resulting in MRSA Empyema.Cureus · 2024Article
- Identification and Clinical Characteristics of Community-AcquiredAntibiotics (Basel, Switzerland) · 2024Article
- Gastrointestinal symptoms in COVID-19 and disease severity: a Japanese registry-based retrospective cohort study.Journal of gastroenterology · 2024Article
- Acute neutrophilic vasculitis (leukocytoclasia) in 36 COVID-19 autopsy brains.Diagnostic pathology · 2024Article
- Clinical utilization of artificial intelligence-based COVID-19 pneumonia quantification using chest computed tomography - a multicenter retrospective cohort study in Japan.Respiratory research · 2023Article
- Review
- Multimorbidity clusters and their association with secondary bacterial infections and disease severity among hospitalised COVID-19 patients in Victoria, Australia: Insights from population-wide linked data.Journal of multimorbidity and comorbidityArticle
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Authors and funding
100 authors at 20 institutions in 1 country.
Kensuke NakagawaraDivision of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan.
Hirofumi KamataDivision of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan. h-kamata@a2.keio.jp.
Shotaro ChubachiDivision of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan.
Ho NamkoongDepartment of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan.
Hiromu TanakaDivision of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan.
Ho LeeDivision of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan.
Shiro OtakeDivision of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan.
Takahiro FukushimaDivision of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan.
Tatsuya KusumotoDivision of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan.
Atsuho MoritaDivision of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan.
Shuhei AzekawaDivision of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan.
Mayuko WataseDivision of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan.
Takanori AsakuraDivision of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan.
Katsunori MasakiDivision of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan.
Makoto IshiiDivision of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan.
Akifumi EndoClinical Research Center, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan.
Ryuji KoikeClinical Research Center, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan.
Hiroyasu IshikuraDepartment of Emergency and Critical Care Medicine, Faculty of Medicine, Fukuoka University Hospital, Fukuoka, Japan.
Tohru TakataDepartment of Infection Control, Fukuoka University, Fukuoka, Japan.
Yasushi MatsushitaDepartment of Internal Medicine and Rheumatology, Faculty of Medicine and Graduate School of Medicine, Juntendo University, Tokyo, Japan.
Norihiro HaradaDepartment of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Juntendo University, Tokyo, Japan.
Hiroyuki KokutouFukujuji Hospital, Kiyose, Japan.
Takashi YoshiyamaFukujuji Hospital, Kiyose, Japan.
Kensuke KataokaDepartment of Respiratory Medicine and Allergy, Tosei General Hospital, Seto, Japan.
Yoshikazu MutohDepartment of Infectious Diseases, Tosei General Hospital, Seto, Japan.
Masayoshi MiyawakiDepartment of Internal Medicine, JCHO (Japan Community Health Care Organization, Saitama Medical Center, Saitama, Japan.
Soichiro UedaDepartment of Internal Medicine, JCHO (Japan Community Health Care Organization, Saitama Medical Center, Saitama, Japan.
Hiroshi OnoDivision of Infectious Diseases and Respiratory Medicine, Kumamoto Medical Center, Kumamoto, Japan.
Takuya OnoEmergency and Critical Care Medicine, Tokyo Women's Medical University Adachi Medical Center, Tokyo, Japan.
Tomohisa ShokoEmergency and Critical Care Medicine, Tokyo Women's Medical University Adachi Medical Center, Tokyo, Japan.
Hiroyuki MuranakaDivision of Respiratory Medicine, Social Welfare Organization Saiseikai Imperial Gift Foundation, Inc, Saiseikai Kumamoto Hospital, Kumamoto, Japan.
Kodai KawamuraDivision of Respiratory Medicine, Social Welfare Organization Saiseikai Imperial Gift Foundation, Inc, Saiseikai Kumamoto Hospital, Kumamoto, Japan.
Nobuaki MoriDepartment of General Internal Medicine and Infectious Diseases, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.
Takao MochimaruDepartment of Respiratory Medicine, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.
Mototaka FukuiUji-Tokushukai Medical Center, Uji, Japan.
Yusuke ChiharaUji-Tokushukai Medical Center, Uji, Japan.
Yoji NagasakiDepartment of Respirology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.
Masaki OkamotoDepartment of Respirology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.
Masaru AmishimaDepartment of Respiratory Medicine, National Hospital Organization Hokkaido Medical Center, Sapporo, Japan.
Toshio OdaniDepartment of Rheumatology, National Hospital Organization Hokkaido Medical Center, Sapporo, Japan.
Mayuko TaniIshikawa Prefectural Central Hospital, Kanazawa, Japan.
Koichi NishiIshikawa Prefectural Central Hospital, Kanazawa, Japan.
Yuya ShiraiDepartment of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, Osaka, Japan.
Ryuya EdahiroDepartment of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, Osaka, Japan.
Akira AndoDepartment of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Naozumi HashimotoDepartment of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Shinji OguraDepartment of Emergency and Disaster Medicine, Gifu University Graduate School of Medicine, Gifu, Japan.
Yuichiro KitagawaDepartment of Emergency and Disaster Medicine, Gifu University Graduate School of Medicine, Gifu, Japan.
Toshiyuki KitaNational Hospital Organization Kanazawa Medical Center, Kanazawa, Japan.
Takashi KagayaNational Hospital Organization Kanazawa Medical Center, Kanazawa, Japan.
Yasuhiro KimuraDepartment of Respiratory Medicine, Saiseikai Yokohamashi Nanbu Hospital, Yokohama, Japan.
Naoki MiyazawaDepartment of Respiratory Medicine, Saiseikai Yokohamashi Nanbu Hospital, Yokohama, Japan.
Tomoya TsuchidaDivision of General Internal Medicine, Department of Internal Medicine, St. Marianna University School of Medicine Kawasaki, Kawasaki, Japan.
Shigeki FujitaniDepartment of Emergency and Critical Care Medicine, St. Marianna University School of Medicine, Kawasaki, Japan.
Koji MurakamiDepartment of Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
Hirohito SanoDepartment of Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
Yuki SatoDepartment of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan.
Yoshinori TaninoDepartment of Pulmonary Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan.
Ryo OtsukiDepartment of Respiratory Medicine, Toyohashi Municipal Hospital, Toyohashi, Japan.
Shuko MashimoDepartment of Respiratory Medicine, Toyohashi Municipal Hospital, Toyohashi, Japan.
Mizuki KuramochiDepartment of Gastroenterology, National Hospital Organization Saitama National Hospital, Wako, Saitama, Japan.
Yasuo HosodaDepartment of Gastroenterology, National Hospital Organization Saitama National Hospital, Wako, Saitama, Japan.
Yoshinori HasegawaDepartment of Respiratory Medicine, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan.
Tetsuya UedaDepartment of Respiratory Medicine, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan.
Yotaro TakakuDepartment of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Kumagaya, Japan.
Takashi IshiguroDepartment of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Kumagaya, Japan.
Akiko FujiwaraDepartment of Medicine, Division of Allergology and Respiratory Medicine, Showa University Koto Toyosu Hospital, Tokyo, Japan.
Naota KuwaharaDepartment of Medicine, Division of Allergology and Respiratory Medicine, Showa University Koto Toyosu Hospital, Tokyo, Japan.
Hideya KitamuraDepartment of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan.
Eri HagiwaraDepartment of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan.
Yasushi NakamoriDepartment of Emergency and Critical Care Medicine, Kansai Medical University General Medical Center, Osaka, Japan.
Fukuki SaitoDepartment of Emergency and Critical Care Medicine, Kansai Medical University General Medical Center, Osaka, Japan.
Yuta KonoDepartment of Respiratory Medicine, Tokyo Medical University Hospital, Tokyo, Japan.
Shinji AbeDepartment of Respiratory Medicine, Tokyo Medical University Hospital, Tokyo, Japan.
Tomoo IshiiTokyo Medical University Ibaraki Medical Center, Inashiki, Japan.
Takehiko OhbaDepartment of Respiratory Medicine, Ome Municipal General Hospital, Ome, Tokyo, Japan.
Yu KusakaDepartment of Respiratory Medicine, Ome Municipal General Hospital, Ome, Tokyo, Japan.
Hiroko WatanabeDivision of Respiratory Medicine, Tsukuba Kinen General Hospital, Ibaraki, Japan.
Makoto MasudaDepartment of Respiratory Medicine, Fujisawa City Hospital, Fujisawa, Japan.
Hiroki WatanabeDepartment of Respiratory Medicine, Fujisawa City Hospital, Fujisawa, Japan.
Yoshifumi KimizukaDivision of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College, Saitama, Japan.
Akihiko KawanaDivision of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College, Saitama, Japan.
Yu KasamatsuDepartment of Infection Control and Laboratory Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Satoru HashimotoDepartment of Anesthesiology and Intensive Care Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Yukinori OkadaDepartment of Statistical Genetics, Osaka University Graduate School of Medicine, Osaka, Japan.
Tomomi TakanoSchool of Veterinary Medicine, Kitasato University, Towada, Japan.
Kazuhiko KatayamaLaboratory of Viral Infection I, Department of Infection Control and Immunology, Ōmura Satoshi Memorial Institute & Graduate School of Infection Control Sciences, Kitasato University, Tokyo, Japan.
Masumi AiDepartment of Insured Medical Care Management, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan.
Atsushi KumanogohDepartment of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, Osaka, Japan.
Toshiro SatoDepartment of Organoid Medicine, Keio University School of Medicine, Tokyo, Japan.
Katsushi TokunagaGenome Medical Science Project (Toyama), National Center for Global Health and Medicine, Tokyo, Japan.
Seiya ImotoDivision of Health Medical Intelligence, Human Genome Center, the Institute of Medical Science, the University of Tokyo, Tokyo, Japan.
Yuko KitagawaDepartment of Surgery, Keio University School of Medicine, Tokyo, Japan.
Akinori KimuraInstitute of Research, Tokyo Medical and Dental University, Tokyo, Japan.
Satoru MiyanoM&D Data Science Center, Tokyo Medical and Dental University, Tokyo, Japan.
Naoki HasegawaDepartment of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan.
Seishi OgawaDepartment of Pathology and Tumor Biology, Kyoto University, Kyoto, Japan.
Takanori KanaiDivision of Gastroenterology and Hepatology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.
Koichi FukunagaDivision of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan.
Japan COVID-19 Task Force
Keio University · JPOsaka University · JPNagoya University · JPNational Hospital Organization · JPTokyo Medical and Dental University Hospital · JPFujisawa City Hospital · JPFukujuji Hospital · JPFukushima Medical University · JPGifu University · JPIshikawa Prefectural Central Hospital · JPJuntendo University · JPKanagawa Cardiovascular and Respiratory Center · JPKanazawa Medical Center · JPKansai Medical University · JPKitasato University · JPKyoto Prefectural University of Medicine · JPNational Defense Medical College · JPNational Hospital Organization Hokkaido Medical Center · JPNational Kyushu Medical Center · JPOme Municipal General Hospital · JP
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough cases of respiratory bacterial infections associated with coronavirus disease 2019 (COVID-19) have often been reported, their impact on the clinical course remains unclear. Herein, we evaluated and analyzed the complication rates of bacterial infections, causative organisms, patient backgrounds, and clinical outcome in Japanese patients with COVID-19.
methodsWe performed a retrospective cohort study that included inpatients with COVID-19 from multiple centers participating in the Japan COVID-19 Taskforce (April 2020 to May 2021) and obtained demographic, epidemiological, and microbiological results and the clinical course and analyzed the cases of COVID-19 complicated by respiratory bacterial infections.
resultsOf the 1,863 patients with COVID-19 included in the analysis, 140 (7.5%) had respiratory bacterial infections. Community-acquired co-infection at COVID-19 diagnosis was uncommon (55/1,863, 3.0%) and was mainly caused by Staphylococcus aureus, Klebsiella pneumoniae and Streptococcus pneumoniae. Hospital-acquired bacterial secondary infections, mostly caused by Staphylococcus aureus, Pseudomonas aeruginosa, and Stenotrophomonas maltophilia, were diagnosed in 86 patients (4.6%). Severity-associated comorbidities were frequently observed in hospital-acquired secondary infection cases, including hypertension, diabetes, and chronic kidney disease. The study results suggest that the neutrophil-lymphocyte ratio (> 5.28) may be useful in diagnosing complications of respiratory bacterial infections. COVID-19 patients with community-acquired or hospital-acquired secondary infections had significantly increased mortality.
conclusionsRespiratory bacterial co-infections and secondary infections are uncommon in patients with COVID-19 but may worsen outcomes. Assessment of bacterial complications is important in hospitalized patients with COVID-19, and the study findings are meaningful for the appropriate use of antimicrobial agents and management strategies.
Indexed as
Bacterial InfectionsCoinfectionCommunity-Acquired InfectionsCOVID-19Cross InfectionRespiratory Tract InfectionsStaphylococcal InfectionsCOVID-19 TestingDisease ProgressionEast Asian PeopleHumansRetrospective StudiesSARS-CoV-2Intensive care unitInvasive mechanical ventilationMortalityNeutrophil–lymphocyte ratioSARS-CoV-2 infection
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