Behavior of coinfections and superinfections in COVID-19 patients admitted to the intensive care unit at Hermanos Ameijeiras Hospital

Abstract

Introduction: COVID-19 is associated with an increase in the number of admissions to the intensive care units. The likelihood of fatality cases increases with coinfections and superinfections.

Objective: To determine the presence of coinfections and the occurrence of superinfections in COVID-19 patients admitted to the intensive care unit, its associated factors and its relationship with mortality.

Methods: It was conducted a cross-sectional analytic study in 79 patients with positive SARS-CoV-2 tests during eight months in the intensive care units at Hermanos Ameijeiras Hospital. Demographic, clinical and management variable were studied. Categorical variables were expressed in terms of absolute and relative frequencies. Quantitative variables were described based on their median and their interquartile ranges. The Wilcoxon rank test, Pearson's chi-squared test and the multinomial logistic regression model were used to determine the independent predictor variables of superinfection.

Results: Superinfection occurred in 34 patients (43%). The mortality rate was 43% with 34 patients, of which 18 had superinfections. A causal association was established between superinfection and hospital stay (OR: 1.56; CI: 95%: 1.26-2.08; p < 0.001), the use of invasive mechanical ventilation (OR: 3.28; CI: 95%: 1.30-8.73; p = 0.014) and the time this procedure was used (OR: 1.37; CI: 95%: 1.15-1.71; p < 0.001).

Conclusions: No statistical association was found between mortality and superinfection in the patients under study. There was low presence of coinfections. The stay in the intensive care unit, the use of invasive mechanical ventilation and the time this procedure was used were predictive variables for the occurrence of superinfection.