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COVID-19 Clinical Profiles and Fatality Rates in Hospitalized Patients Reveal Case Aggravation and Selective Co-Infection by Limited Gram-Negative Bacteria

Author

Listed:
  • Kamaleldin B. Said

    (Department of Pathology, College of Medicine, University of Ha’il, Ha’il 55476, Saudi Arabia
    Genomics, Bioinformatics and Systems Biology, Carleton University, 1125 Colonel-By Dr, Ottawa, ON K1S 5B6, Canada
    ASC, McGill University, 21111 Lakeshore Rd, Montreal, QC H9X 3L9, Canada)

  • Ahmed Alsolami

    (Department of Internal Medicine, College of Medicine, University of Ha’il, Ha’il 55476, Saudi Arabia)

  • Safia Moussa

    (Department of Microbiology, King Salman Specialist Hospital, Ha’il 55476, Saudi Arabia)

  • Fayez Alfouzan

    (Department of Microbiology, King Salman Specialist Hospital, Ha’il 55476, Saudi Arabia)

  • Abdelhafiz I. Bashir

    (Department of Physiology, College of Medicine, University of Ha’il, Ha’il 55476, Saudi Arabia)

  • Musleh Rashidi

    (Ministry of Health, Hail Region, Ha’il 55476, Saudi Arabia)

  • Rana Aborans

    (Department of Community Medicine, Faculty of Medicine, University of Ha’il, Ha’il 55476, Saudi Arabia)

  • Taha E. Taha

    (Department of Epidemiology, John Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA)

  • Husam Almansour

    (Health Management Department, College of Public Health and Health Informatics, University of Ha’il, Ha’il 81481, Saudi Arabia)

  • Mashari Alazmi

    (College of Computer Science and Engineering, University of Ha’il, Ha’il 81481, Saudi Arabia)

  • Amal Al-Otaibi

    (Department of Pathology, College of Medicine, University of Ha’il, Ha’il 55476, Saudi Arabia)

  • Luluh Aljaloud

    (Department of Pathology, College of Medicine, University of Ha’il, Ha’il 55476, Saudi Arabia)

  • Basmah Al-Anazi

    (Department of Pathology, College of Medicine, University of Ha’il, Ha’il 55476, Saudi Arabia)

  • Ahmed Mohialdin

    (Department of Surgery, College of Medicine, University of Ha’il, Ha’il 55476, Saudi Arabia)

  • Ahmed Aljadani

    (Department of Internal Medicine, College of Medicine, University of Ha’il, Ha’il 55476, Saudi Arabia)

Abstract

Bacterial co-infections may aggravate COVID-19 disease, and therefore being cognizant of other pathogens is imperative. We studied the types, frequency, antibiogram, case fatality rates (CFR), and clinical profiles of co-infecting-pathogens in 301 COVID-19 patients. Co-infection was 36% ( n = 109), while CFR was 31.2% compared to 9.9% in non-co-infected patients (z-value = 3.1). Four bacterial species dominated, namely, multidrug-resistant Klebsiella pneumoniae (37%, n = 48), extremely drug-resistant Acinetobacter baumannii (26%, n = 34) , multidrug-resistant Eschericia. coli (18.6%, n = 24), and extremely drug-resistant Pseudomonas aeruginosa (8.5%, n = 11), in addition to other bacterial species (9.3%, n = 12). Increased co-infection of K. pneumoniae and A. baumannii was associated with increased death rates of 29% ( n = 14) and 32% ( n = 11), respectively. Klebsiella pneumoniae was equally frequent in respiratory and urinary tract infections (UTI), while E. coli mostly caused UTI (67%), and A. baumannii and P. aeruginosa dominated respiratory infections (38% and 45%, respectively). Co-infections correlated with advance in age: seniors ≥ 50 years (71%), young adults 21–49 years (25.6%), and children 0–20 years (3%). These findings have significant clinical implications in the successful COVID-19 therapies, particularly in geriatric management. Future studies would reveal insights into the potential selective mechanism(s) of Gram-negative bacterial co-infection in COVID-19 patients.

Suggested Citation

  • Kamaleldin B. Said & Ahmed Alsolami & Safia Moussa & Fayez Alfouzan & Abdelhafiz I. Bashir & Musleh Rashidi & Rana Aborans & Taha E. Taha & Husam Almansour & Mashari Alazmi & Amal Al-Otaibi & Luluh Al, 2022. "COVID-19 Clinical Profiles and Fatality Rates in Hospitalized Patients Reveal Case Aggravation and Selective Co-Infection by Limited Gram-Negative Bacteria," IJERPH, MDPI, vol. 19(9), pages 1-16, April.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:9:p:5270-:d:802584
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    References listed on IDEAS

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    1. Abdulaziz Alqahtani & Edrous Alamer & Mushtaq Mir & Ali Alasmari & Mohammed Merae Alshahrani & Mohammed Asiri & Irfan Ahmad & Abdulaziz Alhazmi & Abdullah Algaissi, 2022. "Bacterial Coinfections Increase Mortality of Severely Ill COVID-19 Patients in Saudi Arabia," IJERPH, MDPI, vol. 19(4), pages 1-11, February.
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