Risk Factor for Superimposed Nosocomial Bloodstream Infections in Hospitalized Patients with COVID-19.

Abstract

Corticosteroids are a component of the standard therapy for patients with coronavirus disease 2019 (COVID-19) because of the immunological dysregulation and hyperinflammation associated with the condition. This study aimed to evaluate the potential risk factors for nosocomial bloodstream infections in hospitalized patients with COVID-19, including the exploration of corticosteroid dosage and treatment duration. A retrospective cohort study of hospitalized patients with COVID-19 was conducted in a tertiary care hospital. We performed univariate and multivariate analyses of various parameters to identify risk factors for nosocomial bloodstream infection. Of 252 patients, 19% had nosocomial bloodstream infections. The mortality rate of nosocomial bloodstream infections was 62.5%. Multivariate analysis revealed that male sex (odds ratio [OR] 3.43; 95% confidence interval [CI]: 1.60-7.33), receiving methylprednisolone (OR: 3.01; 95% CI: 1.24-7.31), receiving an equivalent dexamethasone dose of 6-12 mg/day (OR: 7.49; 95% CI: 2.08-26.94), and leukocytosis on admission (OR: 4.13; 95% CI: 1.89-9.01) were significant predictors of nosocomial bloodstream infections. Unmodified risk variables for nosocomial bloodstream infections included male sex and leukocytosis at admission. Using methylprednisolone and obtaining a cumulative dosage of dexamethasone were adjusted risk variables associated with superimposed nosocomial bloodstream infections in hospitalized patients with COVID-19.