Investigation of microbial coinfection in 453 septic COVID-19 patients admitted to hospital; a retrospective study

Abstract

Aim: We evaluated the rate of COVID-19 microbial coinfection in an Iranian population. Methods: In this single-center, retrospective observational study, we evaluated 453 septic COVID-19 patients for possible coinfection in an Iranian hospital. Results: Overall, 211 (46.57%) cases died due to COVID-19 complications. Positive respiratory secretion and blood cultures were reported in 99 (21.9%) and 19 (4.2%) cases. Klebsiella species were the most commonly isolated microorganisms in respiratory (n = 50, 50.5%) and blood (n = 10, 52.6%) specimens. After adjustment for underlying disorders, positive respiratory microbial cultures significantly increase the odds of developing death, intubation, and ICU admission and negatively impact healthy discharge (P < 0.05). Conclusion: Coinfections with bacteria and fungi independently contribute to poor outcomes in septic COVID-19 patients. Plain language summary COVID-19 bacterial/fungal coinfection is associated with severe mortality rates as it complicates the primary viral infection. This study evaluated 453 patients admitted to an Iranian hospital with COVID-19 and concomitant sepsis for microbial coinfection. A total of 99 (21.9%) cases had positive respiratory secretion cultures, and 19 (4.2%) had positive blood cultures. Klebsiella species were the most commonly yielded microorganism in both respiratory (n = 50, 50.5%) and blood (n = 10, 52.6%) specimens. Bacterial and fungal microbial coinfection are independent determinants of poor outcomes in septic COVID-19 cases.