SESSION TITLE: Chest Infections Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: Bacterial and fungal infections in COVID-19 patients have been inadequately studied and reported The purpose of this study is to determine the incidence and outcomes of superinfections in patients with COVID-19 METHODS: A retrospective observational study of all patients diagnosed with COVID-19 at Fairview Hospital-Cleveland Clinic Main outcomes were incidence of bacterial, viral and fungal infections among COVID-19 patients and in-hospital mortality RESULTS: There were 82 patients diagnosed with COVID-19 Fifty-one (62 2%) were male and median age was 64 5 years On admission, 48 (58 5%) patients were admitted to ICU and 13 (15 9%) required mechanical ventilation Of all patients, 22 (26 8%) developed superinfection during admission Only three had positive PCR for other viruses;two had respiratory syncytial virus and one had influenza A Methicillin resistant staphylococcus aureus (MRSA) was detected in 5 (6 1%) patients Superimposed bacterial pneumonia were detected in 13 (12 2%) patients;2 MRSA, 2 methicillin sensitive staphylococcus aureus, 2 Corynebacterium striatum, 2 pseudomonas aeruginosa, 2 mycoplasma pneumoniae, 1 legionella, 1 serratia marcescens and 1 klebsiella pneumoniae Only one patient had aspergillus fumigatus lung infection Positive blood cultures were detected in 4 (4 9%) patients and included a case of candidemia Urinary tract infection was diagnosed in 10 (72%) patients, and only 2 had a foley’s catheter Corticosteroids were used in the treatment of 37 (45 1%) patients, with only 8 of the 22 patients who developed superinfections Compared to the no superinfection cohort, patients who developed superinfection were more likely to require ICU admission (77 3% vs 53 3%, p 0 05), develop circulatory shock (59 1% vs 30 0%, p 0 016), require mechanical ventilation (63 6% vs 33 3%, p 0 014) and had lower median absolute lymphocytes count (1455/mm3 vs 5700/mm3, p 0 006) In multivariate analysis, circulatory shock (p 0 046) and need for mechanical ventilation (p 0 037) remained significantly associated with superinfection Median time to superinfection development was 5 days with an overall mortality of 19 5% The mean overall survival time among patients who developed superinfections was not significantly different compared to no superinfection group, 53 5 days (95% CI: 46 7-60 3) and 48 5 days (95% CI: 42 6-54 5) respectively, (p 0 278) CONCLUSIONS: In our COVID-19 cohort the rate of superinfection was 26 8% Superinfection was associated with higher rates of circulatory shock and mechanical ventilation The use of corticosteroids was not associated with higher rates of infections CLINICAL IMPLICATIONS: This study will help in identifying frequent infections among COVID-19 patients in an attempt to predict and treat superinfections early in the course of the disease DISCLOSURES: No relevant relationships by Saira Afzal, source=Web Response No relevant relationships by Sura Alqaisi, source=Web Response No relevant relationships by Sanchit Chawla, source=Web Response No relevant relationships by Tariq Kewan, source=Web Response No relevant relationships by Aisha Saand, source=Web Response No relevant relationships by Talha Saleem, source=Web Response
Superinfections in Patients Infected with Covid-19: a Single-center Experience