Hospitalised patients with COVID-19: the impact of nosocomial infections

Abstract

<b>Introduction:</b> COVID-19 is a disease caused by the SARS-CoV-2 virus. Healthcare-associated infections (HCAI) are infections acquired during a stay in a hospital or other healthcare setting that were not incubating at the time of admission. <b>Objective:</b> To describe the impact of HCAI in hospitalised patients with COVID-19. <b>Methods:</b> A retrospective and descriptive study of hospitalised patients with COVID-19 in a Portuguese hospital in 2020 was conducted. <b>Results:</b> The sample consisted of 1110 patients of whom 229 acquired HCAI. The main comorbidities were hypertension 62.45% (n=143), obesity 24.01% (n=55), arrhythmias 20.52% (n=47), ischaemic heart 11.35% (n=26) and heart failure 16.16%. Infectious agents were isolated in 27.95% (n=64), with <i>Escherichia col</i>i and <i>Klebsiella pneumoniae</i> being the most frequent. HCAI´s classification were: 5.68% (n=13) nosocomial bacteraemia 31.89% (n=73); urinary tract infection 54.15% (n=124); hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia 8.28% (n=19). Ventilatory support required: 14.85% (n=34) didn´t require, 49.34% (n=113) conventional oxygen therapy (COT); 2.62% (n=6) high flow therapy, 3.06% (n=7) non-invasive ventilation, 16.16% (n=37) Helmet-CPAP, 12.66% (n=29) invasive mechanical ventilation (IMV) and 1.31% (n=3) ECMO. The mean number of days of admission was 14.84 (±13.67).&nbsp;The probability of death&nbsp;HCAI´s patients was OR 1.63, 95% CI 1.154-2.304. <b>Conclusion:</b> The sample shows a high incidence of nosocomial infections. The most frequent HCAI&nbsp;were HAP mainly with clinical diagnosis. Clinical stabilisation of comorbidities and COT were effective for most patients but IMV and Helmet-CPAP for the most severe. HCAI are a high risk factor for mortality.