Are multiple courses of antibiotics a potential risk factor for COVID-19 infection and severity?

Abstract

Background: To determine the potential risk factor of COVID-19 severity and length of hospitalization, the association between multiple antibiotics administration and the risk of severe COVID-19. Methods: A case-control study of 58 hospitalized COVID-19 patients (the case group) and 120 non-hospitalized home isolated COVID-19 patients (the control group) was conducted. Data were collected using hospital medical records and verbal questionnaires for the participants. Results: Totally 89.2% of non-hospitalized mild COVID-19 patients received ⩽2 courses of antibiotics/year, while 36.0% of hospitalized patients received ⩾4 courses of antibiotics, 56.9% received 2-3 courses of antibiotics/year and only 6.9% of them were exposed to ⩽2 courses of antibiotics/year. our study emphasizes that the usage of 4 courses or higher per year was a significant risk factor for hospitalization [OR: 17.5; 95%CI(2.596-118.263); P=0.003], while the usage of ⩽2 courses was a preventive predictor for severity and hospitalization [OR: 0.072; 95%CI(0.006-0.900); P=0.041]. Furthermore, age was associated with 8.4% increase in the odds of severe COVID-19 [OR: 1.084; 95%CI(1.024-1.148), P=0.005], and females were 89.1% less likely to hospitalized than males [OR: 0.109; 95%CI(0.024-0.498); P= 0.004]. Our study shows that 70.4% of cases misused antibiotics and administered the antibiotics themselves without a physician's prescription. Around 50.0% of cases never completed the ideal duration of the course in contrast to controls, of which only 23.2% did not complete the ideal duration. Conclusions: Our study shows that antibiotics misuse and overuse may be a potential risk factor for COVID-19 severity and hospitalization.