Secondary Infections in COVID-19 Patients Hospitalized in A Tertiary Hospital

Abstract

Objective: In this study, it was aimed to describe rates, etiological agents of the secondary infections and its effect on clinical outcomes among hospitalized patients with COVID-19. Materials and Methods: A retrospective comparative analysis of the characteristics of patients with and without secondary infection was carried out among 150 hospitalized adult patients with a confirmed diagnosis of COVID-19 via RT-PCR.Results: Among included patients, 20 (13.3%) had at least one secondary infection. Secondary infection rate in ICU patients (72%) was significantly higher than patients in the general ward (1.6%) (p<0.001). The prevalence of ventilator-associated pneumonia (VAP) was 52% in ICU patients. The majority of 31 microorganisms isolated were gram negative bacteria. Overall, 147 (98%) patients received at least one antibiotic during their hospitalization. A significantly higher mortality rate was present in patients with secondary infection compared to those without. Conclusion: Since the rate of secondary infection in hospitalized COVID-19 patients in the general ward is very low, we consider that empirical antibiotic therapy should not be initiated in these patients in accordance with the rational use of antibiotics. Besides, we recommend that multidrug-resistant bacteria be taken into account both in the empirical and targeted antimicrobial therapy of VAP infections.