ArticlePloS one2025
The influence of pneumococcal positivity on clinical outcomes among patients hospitalized with COVID-19: A retrospective cohort study.
Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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10 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundBacterial co-infection has been associated with adverse outcomes in patients with COVID-19. Streptococcus pneumoniae is a common cause of community-acquired pneumonia and may contribute to poor clinical outcomes when co-detected in COVID-19 patients. This study aimed to investigate the clinical significance of pneumococcal positivity in hospitalized patients with COVID-19.
methodsWe conducted a retrospective analysis of adult patients hospitalized with COVID-19 at two tertiary care centers. Pneumococcal positivity was defined by either a positive urinary antigen test or multiplex real-time polymerase chain reaction. Disease severity of COVID-19 pneumonia was assessed using the pneumonia severity index and CURB-65 scoring systems. Propensity score matching and multivariable logistic regression were used to adjust for confounders and identify independent risk factors for mortality.
resultsAmong 280 patients, 65 pneumococcus-positive patients were matched with 65 pneumococcus-negative patients after propensity score matching. In the overall matched cohort, pneumococcal positivity was not significantly associated with in-hospital mortality. However, in patients with severe disease (n = 156), defined as pneumonia severity index >130 or CURB-65 ≥ 3, mortality was significantly higher in pneumococcus-positive patients (n = 39) than in pneumococcus-negative patients (53.8% vs. 29.1%, p = 0.009). In the multivariable analysis of this subgroup, pneumococcal positivity (odds ratio, 4.050; 95% confidence interval, 1.285-12.765; p = 0.017) and high-flow oxygen therapy (odds ratio, 6.510; 95% confidence interval, 1.847-22.944; p = 0.004) were independently associated with mortality.
conclusionDetection of S. pneumoniae by urinary antigen test or multiplex polymerase chain reaction was associated with increased mortality in patients hospitalized with severe COVID-19.
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