"PERSISTENT POST-COVID IMMUNOSUPPRESSION AND HEALTHCARE- ASSOCIATED INFECTIONS - POSSIBLE MECHANISMS AND IMPLICATIONS IN MULTIDRUG-RESISTANT INFECTIONS"

Abstract

One of the main concerns of the medical community during the COVID-19 pandemic has been the management of the immunosuppression accompanying the disease, particularly in ICU (Intensive Care Unit) patients. More recently, the focus has shifted towards the management of the persistent immunosuppression post-acute COVID-19 and its complications. The rate of healthcare-associated infections (HAIs) had been declining before the pandemic, but has since started to increase once more. Due to multiple factors – unnecessary antibiotherapy, disorganized medical facilities, inadequate personal protection equipment etc. – there have been increasing reports of coinfections and secondary infections with multidrug-resistant bacteria in COVID-19 patients. We present a case report of a patient with no history of clinically overt immunosuppression before developing critical SARS-CoV-2 pneumonia. The patient had no need for antibiotic treatment during his hospitalization and was discharged in a stable state, being consequently readmitted multiple times for different healthcare-associated multidrug-resistant infections, over time developing other hospital-related complications. The case raises a discussion about the bidirectional relationship between post-COVID immunosuppression and the possible inadvertent excess in antibiotic therapy that has accompanied the pandemic.