Longer Steroid Treatment Increases Secondary Bloodstream Infection Risk Among Patients With COVID-19 Requiring Intensive Care

Amy C. Dupper, Yesha Malik, Jaclyn A. Cusumano, Devika Nadkarni, Jaspreet Banga, Ana Berbel Caban, Kathryn Twyman, Ajay Obla, Dhruv Patel, Dana Mazo, Deena R. Altman

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Background: The global pandemic caused by severe acute respiratory syndrome coronavirus 2 resulted in a large burden of critically ill patients, a population with an increased risk of both developing and dying from secondary infections. We investigated the clinical characteristics, risk factors, and outcomes associated with developing bloodstream infections (BSIs) among those admitted to the intensive care unit (ICU) for coronavirus disease 2019 (COVID-19) during the peak of the first surge in New York City, before the standardization of treatment regimens limited the ability to analyze differences. Methods: We performed a retrospective case-control study including all patients 18 years or older who were admitted to the ICU because of COVID-19 in April 2020 in New York City. Demographic characteristics, risk factors, and outcomes were analyzed between cases, those who developed BSI during ICU admission, and matched controls who did not develop BSI, using a logistic regression. Results: Thirty-two cases and 64 controls, all with COVID-19, were matched on sex, age, and the length of ICU stay before BSI. Cases who developed BSI had higher odds of longer corticosteroid use and a preexisting diagnosis of hypertension at the time of hospital admission than controls without BSI. Conclusions: We found a positive association between the duration of corticosteroids and the development of BSI. Considering immunosuppression is now the cornerstone of guidelines for COVID-19 treatment, further studies are needed to evaluate risks and mitigation strategies for these therapies.

Original languageEnglish
Article numbere1188
JournalInfectious Diseases in Clinical Practice
Volume30
Issue number4
DOIs
StatePublished - 1 Jul 2022

Keywords

  • COVID-19
  • bacteremia
  • coinfection
  • critical care
  • steroids

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