Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Sep 12;58(9):1262.
doi: 10.3390/medicina58091262.

Clinical Presentations, Predictive Factors, and Outcomes of Clostridioides difficile Infection among COVID-19 Hospitalized Patients—A Single Center Experience from the COVID Hospital of the University Clinical Center of Vojvodina, Serbia

Nadica Kovačević  1   2 , Dajana Lendak  1   2 , Milica Popović  1   3 , Aleksandra Plećaš Đuric  1   4 , Maria Pete  1   2 , Vedrana Petrić  1   2 , Siniša Sević  1   2 , Slavica Tomić  1   2 , Jelica Alargić  5 , Dimitrije Damjanov  1   6 , Dijana Kosjer  1   6 , Milica Lekin  1   7
Affiliations

Clinical Presentations, Predictive Factors, and Outcomes of Clostridioides difficile Infection among COVID-19 Hospitalized Patients—A Single Center Experience from the COVID Hospital of the University Clinical Center of Vojvodina, Serbia

Nadica Kovačević et al. Medicina (Kaunas). .

Abstract

Background: This study aimed to investigate the clinical form, risk factors, and outcomes of patients with COVID-19 and Clostridioides difficile co-infections. Methods: This retrospective study (2 September 2021-1 April 2022) included all patients with Clostridioides difficile infection (CDI) and COVID-19 infection who were admitted to the Covid Hospital of the University Clinical Center of Vojvodina. Results: A total of 5124 COVID-19 patients were admitted to the Covid Hospital, and 326 of them (6.36%) developed hospital-onset CDI. Of those, 326 of the CDI patients (88.65%) were older than 65 years. The median time of CDI onset was 12.88 days. Previous hospitalizations showed 69.93% of CDI patients compared to 38.81% in the non-CDI group (p = 0.029). The concomitant antibiotics exposure was higher among the CDI group versus the non-CDI group (88.65% vs. 68.42%, p = 0.037). Albumin levels were ≤ 25 g/L among 39.57% of the CDI patients and 21.71% in the non-CDI patients (p = 0.021). The clinical manifestations of CDI ranged from mild diarrhea (26.9%) to severe diarrhea (63.49%) and a complicated form of colitis (9.81%). Regarding outcomes, 79.14% of the CDI patients recovered and 20.86% had fatal outcomes in-hospital. Although a minority of the patients were in the non-CDI group, the difference in mortality rate between the CDI and non-CDI group was not statistically significant (20.86% vs. 15.13%, p = 0.097). Conclusions: Elderly patients on concomitant antibiotic treatments with hypoalbuminemia and with previous healthcare exposures were the most affected by COVID-19 and CD co-infections.

Keywords: COVID-19; Clostridioides difficile infection; antibiotics; risk factors.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Number of antibiotics used prior to hospitalization.
Figure 2
Figure 2
Antibiotics prescribed prior to hospitalization.
Figure 3
Figure 3
Antibiotics used during patient hospital stays.
See this image and copyright information in PMC

References

    1. Redd W.D., Zhou J.C., Hathorn K.E., Mccarty T.R., Bazarbashi A.N., Thompson C.C., Shen L., Chan W.W. Prevalence and Characteristics of Gastrointestinal Symptoms in Patients with Severe Acute Respiratory Syndrome Coronavirus 2 Infection in the United States: A Multicenter Cohort Study. Gastroenterology. 2020;159:765–767.e2. doi: 10.1053/j.gastro.2020.04.045. - DOI - PMC - PubMed
    1. Cojocariu C., Girleanu I., Trifan A., Olteanu A., Muzica C.M., Huiban L., Chiriac S., Singeap A.M., Cuciureanu T., Sfarti C., et al. Did the severe acute respiratory syndrome-coronavirus 2 pandemic cause an endemic Clostridium difficile infection? World J. Clin. Cases. 2021;9:10180–10188. doi: 10.12998/wjcc.v9.i33.10180. - DOI - PMC - PubMed
    1. Allegretti J.R., Nije C., McClure E., Redd W.D., Wong D., Zhou J.C., Bazarbashi A.N., McCarty T.R., E Hathorn K., Shen L., et al. Prevalence and impact of Clostridioides difficile infection among hospitalized patients with coranavirus disease 2019. JGH Open. 2021;5:622–625. doi: 10.1002/jgh3.12497. - DOI - PMC - PubMed
    1. Rawson T.M., Moore L.S.P., Zhu N., Ranganathan N., Skolimowska K., Gilchrist M., Satta G., Cooke G., Holmes A.H. Bacterial and Fungal Coinfection in Individuals With Coronavirus: A Rapid Review To Support COVID-19 Antimicrobial Prescribing. Clin. Infect. Dis. 2020;71:2459–2468. doi: 10.1093/cid/ciaa530. - DOI - PMC - PubMed
    1. Haque M., Sartelli M., McKimm J., Bin Abu Bakar M. Health care-associated infections—An overview. Infect. Drug Resist. 2018;ume 11:2321–2333. doi: 10.2147/idr.s177247. - DOI - PMC - PubMed