High Risk of Secondary Infections Following Thrombotic Complications in Patients With COVID-19
Author:
Ripa Marco12ORCID, Galli Laura1, D’Angelo Armando3, Apruzzi Luca4, Palumbo Diego25, Campochiaro Corrado6ORCID, Tassan Din Chiara1, Danise Anna1, Da Prat Valentina7, Vitali Giordano8, Brugliera Luigia9, Poli Andrea1, Monardo Roberta12, Monti Giacomo210, Baccellieri Domenico4ORCID, De Cobelli Francesco25, Clementi Massimo211, Iannaccone Sandro9, Dagna Lorenzo26, Rovere-Querini Patrizia28, Ciceri Fabio212ORCID, Tresoldi Moreno7ORCID, Zangrillo Alberto210ORCID, Scarpellini Paolo1, Castagna Antonella12, Andolina Andrea, Bigoloni Alba, Bossolasco Simona, Bruzzesi Elena, Canetti Diana, Castiglioni Barbara, Cernuschi Massimo, Chiurlo Matteo, Cinque Paola, Dell’Acqua Raffaele, Della Torre Liviana, Gianotti Nicola, Guffanti Monica, Hasson Hamid, Messina Emanuela, Morsica Giulia, Nozza Silvia, Ranzenigo Martina, Uberti-Foppa Caterina, Vinci Concetta, Badalucco Ciotta Flavia, Bottanelli Martina, Clemente Tommaso, Mainardi Ilaria, Mori Giovanni, Papaioannu Borjesson Rebecka, Ponta Giacomo, Muccini Camilla, Mastrangelo Andrea, Oltolini Chiara, Spagnuolo Vincenzo, Benassi Luca, Bigai Giorgia, Bozzolo Enrica, Borio Giorgia, Bussolari Cecilia, Calvisi Stefania, Canti Valentina, Castellani Jacopo, Cavallo Ludovica, Cilla Marta, Cinel Elena, Compagnone Nicola, D’Aliberti Teresa, Damanti Sarah, De Lorenzo Rebecca, Di Lucca Giuseppe, Di Terlizzi Gaetano, Dumea Iulia, Farolfi Federica, Ferrante Marica, Frangi Claudia, Gallina Gabriele, Germinario Bruno Nicolò, Lanzillotta Marco, Li Voti Raffaele, Marinosci Alessandro, Martinenghi Sabina, Memoli Massimo, Montagna Marco, Pascali Maria, Patrizi Alessandro, Pomaranzi Chiara, Scotti Raffaella, Strada Silvia, Boffini Nicola, Cavalli Giulio, Della Torre Emanuel, De Luca Giacomo, Farina Nicola, Moroni Luca, Ramirez Giuseppe Alvise, Tomelleri Alessandro, Azzolini Maria Luisa, Baiardo Redaelli Martina, Calabrò Maria Grazia, Casiraghi Giuseppina Maria, Dell’Acqua Antonio, Fresilli Stefano, Guzzo Francesca, Landoni Giovanni, Lombardi Gaetano, Maimeri Nicolò, Moizo Elena, Nisi Francesco Giuseppe, Oriani Alessandro, Ortalda Alessandro, Pasculli Nicola, Pieri Marina, Turi Stefano, Bertoglio Luca, Bilman Victor, Carletti Silvia, Gona Floriana, Mancini Nicasio, Della Valle Patrizia, Molinari Chiara, Poloniato Antonella, Lalla Francesca, Prestifilippo Dario, Sapienza Jacopo, Seghi Federico,
Affiliation:
1. Unit of Infectious and Tropical Diseases, IRCCS San Raffaele Scientific Institute , Milan , Italy 2. Vita-Salute San Raffaele University , Milan , Italy 3. Coagulation Service and Thrombosis Research Unit, IRCCS San Raffaele Scientific Institute , Milan , Italy 4. Department of Vascular Surgery, IRCCS San Raffaele Scientific Institute , Milan , Italy 5. Unit of Radiology, IRCCS San Raffaele Scientific Institute , Milan , Italy 6. Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute , Milan , Italy 7. General Medicine and Advanced Care Unit, IRCCS San Raffaele Scientific Institute , Milan , Italy 8. Internal Medicine, Diabetes, and Endocrinology Unit, IRCCS San Raffaele Scientific Institute , Milan , Italy 9. Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute , Milan , Italy 10. Anesthesia and Intensive Care Department, IRCCS San Raffaele Scientific Institute , Milan , Italy 11. Microbiology and Virology Department, IRCCS San Raffaele Scientific Institute , Milan , Italy 12. Hematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute , Milan , Italy
Abstract
AbstractBackgroundThis study’s primary aim was to evaluate the impact of thrombotic complications on the development of secondary infections. The secondary aim was to compare the etiology of secondary infections in patients with and without thrombotic complications.MethodsThis was a cohort study (NCT04318366) of coronavirus disease 2019 (COVID-19) patients hospitalized at IRCCS San Raffaele Hospital between February 25 and June 30, 2020. Incidence rates (IRs) were calculated by univariable Poisson regression as the number of cases per 1000 person-days of follow-up (PDFU) with 95% confidence intervals. The cumulative incidence functions of secondary infections according to thrombotic complications were compared with Gray's method accounting for competing risk of death. A multivariable Fine-Gray model was applied to assess factors associated with risk of secondary infections.ResultsOverall, 109/904 patients had 176 secondary infections (IR, 10.0; 95% CI, 8.8–11.5; per 1000-PDFU). The IRs of secondary infections among patients with or without thrombotic complications were 15.0 (95% CI, 10.7–21.0) and 9.3 (95% CI, 7.9–11.0) per 1000-PDFU, respectively (P = .017). At multivariable analysis, thrombotic complications were associated with the development of secondary infections (subdistribution hazard ratio, 1.788; 95% CI, 1.018–3.140; P = .043). The etiology of secondary infections was similar in patients with and without thrombotic complications.ConclusionsIn patients with COVID-19, thrombotic complications were associated with a high risk of secondary infections.
Publisher
Oxford University Press (OUP)
Subject
Infectious Diseases,Oncology
Cited by
1 articles.
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