Analysis of Fungal and Bacterial Co-Infections in Mortality Cases among Hospitalized Patients with COVID-19 in Taipei, Taiwan

• Published in: Journal of fungi (Basel) 2022-01, Vol.8 (1), p.91
• Main Authors: Lu, De-En, Hung, Shih-Han, Su, Ying-Shih, Lee, Wen-Sen
• Format: Article
• Language: English
• Subjects: Air pollution; Albumin; Aspergillus; Bacteria; bacterial infections; Candida; Cardiovascular disease; co-infections; Coronary artery; Coronaviruses; COVID-19; Creatinine; Fungal infections; Heart diseases; Hospitalization; Immune system; Influenza; Kidney diseases; Laboratories; Lactic acid; Microorganisms; Mortality; Outdoor air quality; Pathogens; Patients; Pneumonia; Polymerase chain reaction; Prognosis; Respiratory diseases; Respiratory syncytial virus; Risk factors; Severe acute respiratory syndrome coronavirus 2; Streptococcus infections; Viruses
• ISSN: 2309-608X; 2309-608X
• DOI: 10.3390/jof8010091

Fungal or bacterial co-infections in patients with H1N1 influenza have already been reported in many studies. However, information on the risk factors, complications, and prognosis of mortality cases with coronavirus disease 2019 (COVID-19) are limited. We aimed to assess 36 mortality cases of 178 hospitalized patients among 339 patients confirmed to have had SARS-CoV-2 infections in a medical center in the Wenshan District of Taipei, Taiwan, between January 2020 and September 2021. Of these 36 mortality cases, 20 (60%) were men, 28 (77.7%) were aged >65 years, and the median age was 76 (54-99) years. Comorbidities such as hypertension, coronary artery disease, and chronic kidney disease were more likely to be found in the group with length of stay (LOS) > 7 d. In addition, the laboratory data indicating elevated creatinine-phosphate-kinase (CPK) ( < 0.001) and lactic acid dehydrogenase (LDH) ( = 0.05), and low albumin ( < 0.01) levels were significantly related to poor prognosis and mortality. The respiratory pathogens of early co-infections (LOS < 7 d) in the rapid progression to death group ( = 7 patients) were two bacteria (22.2%) and seven species (77.8.7%). In contrast, pathogens of late co-infections (LOS > 7 d) ( = 27 patients) were 20 bacterial (54.1%), 16 (43.2%), and only 1 (2.7%) species. In conclusion, the risk factors related to COVID-19 mortality in the Wenshan District of Taipei, Taiwan, were old age, comorbidities, and abnormal biomarkers such as low albumin level and elevated CPK and LDH levels. Bacterial co-infections are more common with Gram-negative pathogens. However, fungal co-infections are relatively more common with spp. than in mortality cases of COVID-19.