BACTEREMIA IN HOSPITALIZED PATIENT WITH COVID-19: INCIDENCE AND RISK FACTORS

Aim. The aim of the study is to assess the incidence and risk factors of bacteremia in hospitalized patients with COVID-19 during different periods of the pandemic.

Methods. The study included 11203 patients diagnosed with COVID-19 who were hospitalize in Minsk City Clinical Infectious diseases Hospital, from 1 June 2021 to 30 June 2023. The incidence of bacteremia and risk factors associated with its development in conditions of competing risks were assessed using Cox cause-specific regression models. Statistical analysis was performed in R 4.3.4. Results. The study included 11203 patients, of whom 1496 patients had 2971 blood culture tests. The cumulative incidence of bacteremia was 0.86 % during the COVID-19 pandemic before the Omicron variants and 1.63 % during the period of prevalence of SARS-CoV-2 Omicron variants. The predominant etiology was K. pneumoniae (31,7 %), S. aureus (15,3 %), E. coli (15,3 %), A. baumanii (14,2 %). Respiratory failure – HR 3.69 [95 % CI 2.18–6.25], p < 0.01, obesity – HR 3.04 [95 % CI 1.83-5.06], p < 0.01, age – HR 1.04 [95 % CI 1.02–1.07], p < 0.01, male gender – HR 1.94 [95 % CI 1.17–3.20], p < 0.01 were associated with bacteremia incidence in pre-Omicron SARS-CoV-2. During Omicron variants, bacteremia incidence was associated with the presence of liver disease – HR 4.26 [95 % CI 2.37–7.67], p < 0.01, respiratory failure – HR 3.72 [95 % CI 2.14–6.44], p < 0.01, COPD – HR 5.11 [95 % CI 1.50–17.40], p < 0.01. Antibacterial therapy before admission was not associated with incidence of bacteremia – HR 0.86 [95 % CI 0.51–1.16], p = 0.58 pre-Omicron; HR 1.07 [95 % CI 0.52-2.18], p = 0.86 during Omicron).

Conclusion. Incidence of bacteremia increased almost two-fold during SARS-CoV-2 Omicron predominance. Risk factors for bacteremia in the pre-Omicron period included respiratory failure, obesity, male gender, and age, while in the Omicron period, risk factors were liver disease, respiratory failure, and chronic obstructive pulmonary disease. Antibacterial treatment before admission was not associated with in-hospital bacteremia incidence.

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