Bacterial and viral infections among adults hospitalized with COVID‐19, COVID‐NET, 14 states, March 2020–April 2022

Author:

Shah Melisa M.12ORCID,Patel Kadam234,Milucky Jennifer24ORCID,Taylor Christopher A.24,Reingold Arthur56,Armistead Isaac7,Meek James8,Anderson Evan J.910ORCID,Weigel Andy11,Reeg Libby12,Como‐Sabetti Kathryn13,Ropp Susan L.14,Muse Alison15,Bushey Sophrena16,Shiltz Eli17,Sutton Melissa18,Talbot H. Keipp19,Chatelain Ryan20,Havers Fiona P.2421,

Affiliation:

1. Epidemic Intelligence Service Centers for Disease Control and Prevention Atlanta Georgia USA

2. COVID‐19 Emergency Response Team Centers for Disease Control and Prevention Atlanta Georgia USA

3. General Dynamics Information Technology Atlanta Georgia USA

4. Coronavirus Disease 2019–Associated Hospitalization Surveillance Network, Division for Viral Diseases, National Center for Immunization and Respiratory Diseases Centers for Disease Control and Prevention Atlanta Georgia USA

5. California Emerging Infections Program Oakland California USA

6. University of California, Berkely Berkely California USA

7. Colorado Department of Public Health & Environment Denver Colorado USA

8. Connecticut Emerging Infections Program Yale School of Public Health New Haven Connecticut USA

9. Departments of Medicine and Pediatrics Emory University School of Medicine Atlanta Georgia USA

10. Georgia Emerging Infections Program, Georgia Department of Public Health Atlanta Veterans Affairs Medical Center Atlanta Georgia USA

11. Iowa Department of Health Des Moines Iowa USA

12. Michigan Department of Health and Human Services Lansing Michigan USA

13. Minnesota Department of Health Saint Paul Minnesota USA

14. New Mexico Department of Health Santa Fe New Mexico USA

15. New York State Department of Health Albany New York USA

16. University of Rochester School of Medicine and Dentistry Rochester New York USA

17. Ohio Department of Health Columbus Ohio USA

18. Public Health Division Oregon Health Authority Portland Oregon USA

19. Vanderbilt University Medical Center Nashville Tennessee USA

20. Salt Lake County Health Department Salt Lake City Utah USA

21. US Public Health Service Commissioned Corps Rockville Maryland USA

Abstract

AbstractBackgroundBacterial and viral infections can occur with SARS‐CoV‐2 infection, but prevalence, risk factors, and associated clinical outcomes are not fully understood.MethodsWe used the Coronavirus Disease 2019‐Associated Hospitalization Surveillance Network (COVID‐NET), a population‐based surveillance system, to investigate the occurrence of bacterial and viral infections among hospitalized adults with laboratory‐confirmed SARS‐CoV‐2 infection between March 2020 and April 2022. Clinician‐driven testing for bacterial pathogens from sputum, deep respiratory, and sterile sites were included. The demographic and clinical features of those with and without bacterial infections were compared. We also describe the prevalence of viral pathogens including respiratory syncytial virus, rhinovirus/enterovirus, influenza, adenovirus, human metapneumovirus, parainfluenza viruses, and non‐SARS‐CoV‐2 endemic coronaviruses.ResultsAmong 36 490 hospitalized adults with COVID‐19, 53.3% had bacterial cultures taken within 7 days of admission and 6.0% of these had a clinically relevant bacterial pathogen. After adjustment for demographic factors and co‐morbidities, bacterial infections in patients with COVID‐19 within 7 days of admission were associated with an adjusted relative risk of death 2.3 times that of patients with negative bacterial testing. Staphylococcus aureus and Gram‐negative rods were the most frequently isolated bacterial pathogens. Among hospitalized adults with COVID‐19, 2766 (7.6%) were tested for seven virus groups. A non‐SARS‐CoV‐2 virus was identified in 0.9% of tested patients.ConclusionsAmong patients with clinician‐driven testing, 6.0% of adults hospitalized with COVID‐19 were identified to have bacterial coinfections and 0.9% were identified to have viral coinfections; identification of a bacterial coinfection within 7 days of admission was associated with increased mortality.

Funder

Centers for Disease Control and Prevention

Council of State and Territorial Epidemiologists

Publisher

Wiley

Subject

Infectious Diseases,Public Health, Environmental and Occupational Health,Pulmonary and Respiratory Medicine,Epidemiology

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