Secondary Bacterial Infection in COVID-19 Patients in the Special Isolation Intensive Care Unit at Dr. Soetomo General Hospital

Abstract

Background: Secondary bacterial infection in COVID-19 patients considerably has worse outcome than infection on its own. COVID-19 severity and mortality are related to underlying conditions. Comorbidities play important role in secondary bacterial infection. This study aimed to compare patients with and without bacterial secondary infection on comorbidity, length of stay, and mortality in critically ill COVID-19 patients. Methods: This cohort retrospective observational study was conducted in January-June 2021. All patients above 18 years old, were confirmed for COVID-19 from RT-PCR tests, and admitted to special isolation intensive care unit (ICU) were included. Data on age, sex, chronic illness (diabetes mellitus and obesity), infection and inflammatory parameters, length of stay and mortality on 28 days was obtained from the patients' medical records. The data collected were analyzed using Mann-Whitney test for length of stay and Chi-square for mortality. Results: Subjects were 101 patients who confirmed positive for COVID-19 in special isolation ICU, 65 patients (64,4%) had secondary bacterial infections. Patients with secondary bacterial infection had longer length of stay (11 ? 6,87 vs 6,58 ? 2,98 [p=0.001]) and higher mortality compared to those without (37(36,6%) vs 2(1,9%) [p=0.000]). There was no significant difference on comorbidities between patients with and without secondary bacterial infections (p=0.199). Conclusion: Secondary bacterial infection in critically ill COVID-19 patients had longer length of stay and higher mortality. Comorbidities showed no significant difference to secondary bacterial infection.