Dataset Information

Predictors and microbiology of respiratory and bloodstream bacterial infection in patients with COVID-19: living rapid review update and meta-regression.

ABSTRACT:

Objective

To identify risk factors and microbiology associated with respiratory and bloodstream bacterial infection in patients with COVID-19.

Methods

Data Sources: We searched MEDLINE, OVID Epub and EMBASE for published literature up to February 5, 2021.

Study eligibility criteria

Studies including at least 50 patients with COVID-19 in any healthcare setting. Assessment of risk of Bias: We used a validated 10-item risk of bias tool for disease prevalence Methods of data synthesis: The main outcome of interest was the proportion of COVID-19 patients with bloodstream and/or respiratory bacterial co-infection and secondary infection. We performed meta-regression to identify study population factors associated with bacterial infection including healthcare setting, age, comorbidities and COVID-19 medication.

Results

Out of 33,345 studies screened, 171 were included in the final analysis. Bacterial infection data were available from 171,262 patients. The prevalence of co-infection was 5.1% (95% CI: 3.6% to 7.1%) and secondary infection was 13.1% (95% CI: 9.8% to 17.2%). There was a higher odds of bacterial infection in studies with a higher proportion of patients in the intensive care unit (ICU) (adjusted OR 18.8, 95% CI: 6.5 to 54.8). Female sex was associated with a lower odds of secondary infection (adjusted OR 0.73, 95% CI: 0.55 to 0.97) but not co-infection (adjusted OR 1.05, 95% CI: 0.80 to 1.37). The most common organisms isolated included Staphylococcus aureus, coagulase-negative Staphylococci, and Klebsiella species.

Conclusions

While the odds of respiratory and bloodstream bacterial infection are low in patients with COVID-19, meta-regression revealed potential risk factors for infection, including ICU setting and mechanical ventilation. The risk for secondary infection is substantially greater than the risk for co-infection in patients with COVID-19. Understanding predictors of co-infection and secondary infection may help to support improved antibiotic stewardship in patients with COVID-19.

Registration

PROSPERO (ID CRD42021241098).

SUBMITTER: Langford BJ

PROVIDER: S-EPMC8619885 | biostudies-literature |

REPOSITORIES: biostudies-literature

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