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. 2021 Sep 23;9(10):2016.
doi: 10.3390/microorganisms9102016.

Bloodstream Infections in Hospitalized Patients with COVID-19: A Systematic Review and Meta-Analysis

Mariachiara Ippolito  1 , Barbara Simone  1 , Carlotta Filisina  1 , Francesca Romana Catalanotto  1 , Giulia Catalisano  1 , Claudia Marino  1 , Giovanni Misseri  2 , Antonino Giarratano  1   3 , Andrea Cortegiani  1   3
Affiliations

Bloodstream Infections in Hospitalized Patients with COVID-19: A Systematic Review and Meta-Analysis

Mariachiara Ippolito et al. Microorganisms. .

Abstract

Background: Little is known about the occurrence of bloodstream infections in hospitalized patients with COVID-19 and the related clinical consequences. The aim of this systematic review and meta-analysis was to estimate the pooled occurrence of BSIs among hospitalized patients with COVID-19 and mortality of this patient population.

Methods: A systematic search was performed on PubMed, EMBASE, and Web of Science from inception to 19 April 2021. The primary outcome was the occurrence of BSIs among hospitalized patients with COVID-19. The secondary outcome was mortality at the longest available follow-up.

Results: Forty-six studies met the inclusion criteria, with a total of 42,694 patients evaluated. The estimated occurrence of BSIs was 7.3% (95% CI 4.7-1.1%) among hospitalized patients with COVID-19, with a mortality rate of 41% (95% CI 30%-52.8%). The subgroup analysis conducted on patients admitted to ICU provided an estimated occurrence of 29.6% (95% CI 21.7%-38.8%). A higher occurrence of BSI was observed in patients with COVID-19, in comparison with patients without COVID-19 (OR 2.77; 95% CI 1.53-5.02; p < 0.001).

Conclusions: Our analysis estimated the occurrence of BSIs among hospitalized patients with COVID-19 at around 7%. A four-times higher occurrence was estimated among patients admitted to ICU.

Keywords: COVID-19; bloodstream infections; review.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA 2020 flow diagram.
Figure 2
Figure 2
Occurrence of bloodstream infection. Forest plot with the result of single-arm meta-analysis for the occurrence of BSI in patients with COVID-19. BSI, bloodstream infection; CI, confidence interval; Ev, events; Trt, total. (a) Pooled estimated occurrence of bloodstream infection among hospitalized patients with COVID-19. (b) Pooled estimated occurrence of bloodstream infection among patients with COVID-19 admitted to ICU.
Figure 3
Figure 3
Mortality of patients with COVID-19 and bloodstream infection. Forest plot with the result of single-arm meta-analysis for mortality of patients with COVID-19 and BSI. BSI, bloodstream infection; CI, confidence interval; Ev, events; Trt, total.
Figure 4
Figure 4
Occurrence of bloodstream infection in patients with COVID-19 compared with patients without COVID-19. Forest plot with the results of the sensitivity analysis on the occurrence of BSI in patients with COVID-19 compared to patients without COVID-19. BSI, bloodstream infection; CI, confidence interval; Ctrl, controls; Ev, events; Trt, total.
See this image and copyright information in PMC

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