Patients With COVID-19 May Be More Susceptible to Health Care-Associated Infections

Patients hospitalized with vs without COVID-19 infection may be more susceptible to health care-associated infections (HAIs), according to results published in JAMA Network Open. 

Researchers conducted a cross-sectional retrospective study to compare HAI occurrence among inpatients with and without COVID-19 infection. Patient data for this analysis were collected from community hospitals within a large health care system in the United States between January 2019 and March 2022. Outcomes assessed included the occurrence of central line-associated bloodstream infection (CLABSI), catheter-associated urinary tract infection (CAUTI), methicillin-resistant Staphylococcus aureus (MRSA) bacteremia, and Clostridioides difficile infection (CDI). 

The final analysis included data from inpatients without COVID-19 (n=2,184,994) that was captured prior to the pandemic (January-December 2019) and data from inpatients with (n=313,200) and without (n=4,564,375) COVID-19 infection that was captured during the pandemic (January 2020-March 2022).

Among patients with and without COVID-19 infection who were hospitalized during the pandemic, the median ages were 64 and 55 years, 50.9% and 44.1% were men, 51.6% and 59.6% were White, and the mean (SD) length of hospitalization was 8.2 (10.8) and 4.7 (7.5) days, respectively.

The researchers compared HAI incidence rates (IRs) per 100,000 patient-days among the 3 patient groups. Among patients without COVID-19 infection who were hospitalized prior to vs during the pandemic, rates of CLASBI (IR, 8.1 vs 6.9), CAUTI (IR, 8.7 vs 6.1), and MRSA (IR, 3.7 vs 3.7) were similar. With the exception of CDI, the highest rates of CLASBI (IR, 25.4), CAUTI (IR, 16.5), and MRSA (IR, 11.2) were observed among inpatients with COVID-19 infection.

Although rates of health care-associated CDI did not significantly differ between inpatients with vs without COVID-19 infection (IR, 8.9 vs 9.7), CDI rates among those without COVID-19 were higher in 2019 vs 2020 to 2022 (IR, 19.5 vs 9.7).

The researchers noted that potentially reduced resources or altered workflows among health care workers assigned to COVID-19 units may have contributed to the higher HAI rates observed among inpatients with COVID-19 infection.

This study was limited as only 4 HAIs were assessed and the results were not adjusted for clinical and demographic differences among the study population.

According to the researchers, “This analysis suggests that the greatest opportunity to improve outcomes may involve targeting additional resources to provide even greater attention to the hospitalized COVID-19 population.”

This article originally appeared on Infectious Disease Advisor