Volume 27, Number 10—October 2021
Research
Bloodstream Infection Risk, Incidence, and Deaths for Hospitalized Patients during Coronavirus Disease Pandemic
, Prem R. Warde, Eric Knott, Sebastian Arenas, Darryl Pronty, Reinaldo Ramirez, Arely Rego, Miriam Levy, Martin Zak, Dipen J. Parekh, Tanira Ferreira, and Hayley B. Gershengorn
Table 1
Patients characteristics by outcome on bloodstream infection risk, incidence, and deaths for hospitalized patients during coronavirus disease pandemic, Miami, Florida, USA, March 25‒October 27, 2020*
| Characteristic | Full cohort for LCBI analyses, no. (%) |
Central line cohort for CLABSI analyses, no. (%) |
|||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| NHSN LCBI |
NHSN LCBI (HAI) |
||||||||||
| No LCBI | LCBI | p value† | No LCBI | LCBI | p value† | No CLABSI | CLABSI | p value† | |||
| Patient admissions |
10,616 (97.9) |
232
(2.1) |
10,694 (98.6) |
154
(1.4) |
2,840
(98.0) |
58
(2.0) |
|||||
| COVID-19 RT-PCR positive |
854 (8.0) |
64 (28) |
<0.001 |
857 (8.0) |
61 (40) |
<0.001 |
365 (13) |
32 (55) |
<0.001 |
||
| Age, y |
63
(52‒73) |
66
(55‒74) |
0.093 |
63
(52‒73) |
66
(54‒74) |
0.4 |
66
(55‒76) |
66
(56‒72) |
0.3 |
||
| Sex‡ | 0.094 | 0.001 | 0.016 | ||||||||
| M | 5,479 (52) | 134 (58) | 0.094 | 5,512 (52) | 101 (66) | 0.001 | 1,343 (47) | 37 (64) | 0.016 | ||
| F |
5,136 (48) |
98 (42) |
5,181 (48) |
53 (34) |
1,497 (53) |
21 (36) |
|||||
| Race/ethnicity | 0.041 | 0.053 | <0.001 | ||||||||
| Non-Hispanic White | 2,318 (22) | 33 (14) | 2,330 (22) | 21 (14) | 553 (19) | 7 (12) | |||||
| Non-Hispanic Black | 280 (2.6) | 3 (1.3) | 281 (2.6) | 2 (1.3) | 76 (2.7) | 1 (1.7) | |||||
| Hispanic White | 5,152 (49) | 123 (53) | 5,188 (49) | 87 (56) | 1,338 (47) | 33 (57) | |||||
| Hispanic Black | 1,952 (18) | 49 (21) | 1,976 (18) | 25 (16) | 647 (23) | 4 (6.9) | |||||
| Other | 577 (5.4) | 17 (7.3) | 581 (5.4) | 13 (8.4) | 154 (5.4) | 8 (14) | |||||
| Unknown |
337 (3.2) |
7 (3.0) |
338 (3.2) |
6 (3.9) |
72 (2.5) |
5 (8.6) |
|||||
| Payer | <0.001 | <0.001 | 0.077 | ||||||||
| Commercial | 3,849 (36) | 59 (25) | 3,869 (36) | 39 (25) | 741 (26) | 15 (26) | |||||
| Government | 73 (0.7) | 4 (1.7) | 74 (0.7) | 3 (1.9) | 17 (0.6) | 2 (3.4) | |||||
| Medicaid | 1,248 (12) | 35 (15) | 1,254 (12) | 29 (19) | 407 (14) | 12 (21) | |||||
| Medicare | 4,964 (47) | 130 (56) | 5,014 (47) | 80 (52) | 1,597 (56) | 27 (47) | |||||
| Other |
482 (4.5) |
4 (1.7) |
483 (4.5) |
3 (1.9) |
78 (2.7) |
2 (3.4) |
|||||
| BMI, kg/m2§ |
27 (23‒31) |
26 (23‒30) |
0.2 |
27 (23‒31) |
27 (23‒31) |
0.7 |
26 (22‒31) |
28 (25‒33) |
0.028 |
||
| Elixhauser comorbidity index |
15 (4‒29) |
27 (15‒40) |
<0.001 |
15 (4‒29) |
26 (15‒39) |
<0.001 |
23 (11‒36) |
22 (12‒34) |
>0.9 |
||
| Urethral catheter |
3,406 (32) |
126 (54) |
<0.001 |
3,430 (32) |
102 (66) |
<0.001 |
1,249 (44) |
45 (78) |
<0.001 |
||
| Central line |
2,690 (25) |
208 (90) |
<0.001 |
2,754 (26) |
144 (94) |
<0.001 |
NA |
NA |
NA |
||
| Mechanical ventilation |
750 (7.1) |
97 (42) |
<0.001 |
767 (7.2) |
80 (52) |
<0.001 |
569 (20) |
39 (67) |
<0.001 |
||
| Steroid treatment |
3,094 (29) |
127 (55) |
<0.001 |
3,119 (29) |
102 (66) |
<0.001 |
1,155 (41) |
49 (84) |
<0.001 |
||
| ICU admission |
2,043 (19) |
135 (58) |
<0.001 |
2,067 (19) |
111 (72) |
<0.001 |
1,118 (39) |
48 (83) |
<0.001 |
||
| Dialysis |
657 (6.2) |
82 (35) |
<0.001 |
682 (6.4) |
57 (37) |
<0.001 |
312 (11) |
29 (50) |
<0.001 |
||
| SOFA score¶ |
1 (0‒3) |
3 (2‒5) |
<0.001 |
1 (0‒3) |
3 (2‒5) |
<0.001 |
2 (1‒4) |
3 (2‒4) |
0.055 |
||
| Central line duration, d |
0.0 (0.0‒0.3) |
14.2 (5.0‒28.0) |
<0.001 |
0.0 (0.0‒0.4) |
20.8 (10.2‒34.3) |
<0.001 |
5 (3‒11) |
28 (15‒54) |
<0.001 |
||
| Hospital LOS, d |
3.5 (1.9‒6.9) |
18.8 (9.4‒30.9) |
<0.001 |
3.5 (1.9‒6.9) |
24.9 (14.3‒36.7) |
<0.001 |
8 (5‒14) |
29 (20‒50) |
<0.001 |
||
| Deaths in hospital | 258 (2.4) | 50 (22) | <0.001 | 267 (2.5) | 41 (27) | <0.001 | 201 (7.1) | 21 (36) | <0.001 | ||
*Values are no. (%) or median (IQR). BMI, body mass index; CLABSI, central line‒associated bloodstream infection; COVID-19, coronavirus disease; HAI, healthcare associated infection; IQR, interquartile range; LCBI, laboratory-confirmed bloodstream infection; LOS, length of stay; NA, not applicable; NHSN, National Healthcare Safety Network; RT-PCR, reverse transcription PCR; SOFA. sequential organ failure assessment. †Statistical tests performed: Fisher exact test; Wilcoxon rank-sum test; χ2 test of independence. ‡One patient of an unknown sex in the full cohort (did not have an LCBI). §Eight patients had missing BMIs in the full cohort (3 in the CLABSI cohort); none had a bloodstream infection. ¶Indicates patients who had missing SOFA scores: 4,815 (55%) of no LCBI full cohort, 104 (55%) of LCBI full cohort, 4,851 (55%) of no LCBI-HAI full cohort, 68 (56%) of LCBI-HAI full cohort, 1,355 (52%) of no CLABSI, and 25 (57%) of CLABSI patients.