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Meta-Analysis
. 2025 Jan 3;25(1):13.
doi: 10.1186/s12879-024-10420-1.

Risk factors for bloodstream infection in COVID-19 patients in intensive care units: a systematic review and meta-analysis

Jun Wang #  1   2 , Ting Jiang #  3   4
Affiliations
Meta-Analysis

Risk factors for bloodstream infection in COVID-19 patients in intensive care units: a systematic review and meta-analysis

Jun Wang et al. BMC Infect Dis. .

Abstract

Background: Risk factors for bloodstream infection in patients with COVID-19 in the intensive care unit (ICU) remain unclear. The purpose of this systematic review was to study the risk factors for BSI in patients admitted to ICUs for COVID-19.

Methods: A systematic search was performed on PubMed, EMBASE, Cochrane Library, and Web of Science up to July 2024. Data were reported as combined odds ratio (OR) for categorical variables and weighted mean difference (WMD) for continuous variables.

Results: 6914 studies were retrieved, of which 55 were included in the meta-analysis. Men (OR = 1.28, 95% CI: 1.10-1.50, P = 0.006), high SAPS II score (WMD = 6.43, 95% CI: 0.23-12.63, P = 0.042), diabetes (OR = 1.34, 95% CI: 1.04-1.73, P = 0.022), tracheal intubation (OR = 8.68, 95% CI: 4.68-16.08, P < 0.001), mechanical ventilation (OR = 22.00, 95% CI: 3.77-128.328, P < 0.001), ECMO (OR = 2.70, 95% CI: 1.17-6.26, P = 0.020), central venous cannulation (OR = 9.33, 95% CI: 3.06-28.43, P < 0.001), prolonged ICU stay (WMD = 10.37, 95% CI: 9.29-11.44, P < 0.001), methylprednisolone use (OR = 2.24, 95% CI: 1.24-4.04, P = 0.008), and the combination of methylprednisolone and Tocilizumab (OR = 4.54, 95% CI: 1.09-18.88, P = 0.037) were risk factors for ICU-BSI in COVID-19 patients.

Conclusion: We identified 10 risk factors for ICU-BSI in COVID-19 patients. In future studies, these factors can be combined to establish a more comprehensive and accurate prediction model for ICU-BSI in COVID-19 patients. Targeted measures can be taken earlier to control BSI.

Keywords: Bloodstream infection; COVID-19; ICU; Meta-analysis.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of the search strategy
Fig. 2
Fig. 2
Forest plot of univariate data associating BSI risk with (A) gender; (B) SAPS II score; (C) diabetes; (D) hypertension and (E) chronic pulmonary disease for patients with COVID-19 in ICU
Fig. 3
Fig. 3
Forest plot of univariate data associating BSI risk with (A) liver disease; (B) chronic kidney disease; (C) heart disease; (D) immunosuppressive disease and (E) tumors for patients with COVID-19 in ICU
Fig. 4
Fig. 4
Forest plot of univariate data associating BSI risk with (A) tracheal intubation; (B) mechanical ventilation; (C) ECMO; (D) CVC; (E) RRT and (F) Length of stay in ICU for patients with COVID-19 in ICU
Fig. 5
Fig. 5
Forest plot of univariate data associating BSI risk with (A) Tocilizumab; (B) Methylprednisolone; (C) Methylprednisolone and Tocilizumab combination; (D) Steroids; (E) Remdesivir and (F) Dexamethasone for patients with COVID-19 in ICU
Fig. 6
Fig. 6
Publication bias of univariate data associating BSI risk with (A) gender; (B) diabetes; (C) chronic pulmonary disease; (D) hypertension and (E) heart disease for patients with COVID-19 in ICU
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