ArticleEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2024
Risk factors, outcomes, and epidemiological and etiological study of hospitalized COVID-19 patients with bacterial co-infection and secondary infections.
Article in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed, 15 citations in OpenAlex.
- Antibiotic Use, Bacterial Co-Infection, and Antimicrobial Resistance in Adults Hospitalized with COVID-19, Influenza, or RSV: A Systematic Review and Meta-Analysis.Antibiotics (Basel, Switzerland) · 2026Review
- Risk Factors of Secondary Bacterial Infection in Patients Hospitalized with COVID-19.Journal of clinical medicine · 2026Article
- Secondary infection in severe COVID-19 patients: clinical and microbial patterns at a tertiary hospital in Vietnam.BMC infectious diseases · 2025Article
- Prognostic factors for mortality and respiratory failure in hospitalized patients with COVID-19 after three-dose vaccination: a retrospective cohort study during the Omicron period.BMC infectious diseases · 2025Observational
- Chronic Pulmonary Aspergillosis Secondary Infection: A Case Report ofClinical case reports · 2025Article
- Dual threat: Susceptibility mechanisms and treatment strategies for COVID-19 and bacterial co-infections.Computational and structural biotechnology journal · 2025Review
- Identifying risk factors for bacterial infections and drivers of antibiotic use in patients without bacterial infections during the COVID-19 pandemic in a low-middle-income country.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- The effect of antibiotic prescription in non-critically ill hospitalized patients with COVID-19: A Japanese inpatient database study.PloS one · 2025Article
- Burden and Risk Factors for Coinfections in Patients with a Viral Respiratory Tract Infection.Pathogens (Basel, Switzerland) · 2024Article
- The Impact of Early Antibiotic Use on Clinical Outcomes of Patients Hospitalized with COVID-19: A Propensity Score-Matched Analysis.Infection and drug resistance · 2024Article
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundAs a common complication of viral respiratory tract infection, bacterial infection was associated with higher mortality and morbidity. Determining the prevalence, culprit pathogens, outcomes, and risk factors of co-infection and secondary infection occurring in hospitalized patients with coronavirus disease 2019 (COVID-19) will be beneficial for better antibiotic management.
methodsIn this retrospective cohort research, we assessed clinical characteristics, laboratory parameters, microbiologic results, and outcomes of laboratory-confirmed COVID-19 patients with bacterial co-infection and secondary infection in West China Hospital from 2022 December 2nd to 2023 March 15th.
resultsThe incidence of bacterial co-infection and secondary infection, as defined by positive culture results of clinical specimens, was 16.3% (178/1091) and 10.1% (110/1091) respectively among 1091 patients. Acinetobacter, Klebsiella, and Pseudomonas were the most commonly identified bacteria in respiratory tract samples of COVID-19 patients. In-hospital mortality of COVID-19 patients with co-infection (17.4% vs 9.5%, p = 0.003) and secondary infection (28.2% vs 9.5%, p < 0.001) greatly exceeded that of COVID-19 patients without bacterial infection. Cardiovascular disease (1.847 (1.202-2.837), p = 0.005), severe COVID-19 (1.694 (1.033-2.778), p = 0.037), and critical COVID-19 (2.220 (1.196-4.121), p = 0.012) were proved to be risk factors for bacterial co-infection, while only critical COVID-19 (1.847 (1.202-2.837), p = 0.005) was closely related to secondary infection.
conclusionsBacterial co-infection and secondary infection could aggravate the disease severity and worsen clinical outcomes of COVID-19 patients. Notably, only critical COVID-19 subtype was proved to be an independent risk factor for both co-infection and secondary infection. Therefore, standard empirical antibiotics was recommended for critically ill COVID-19 rather than all the inpatients according to our research.
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