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- Title
All-cause mortality and disease progression in SARS-CoV-2-infected patients with or without antibiotic therapy: an analysis of the LEOSS cohort.
- Authors
Schons, Maximilian J.; Caliebe, Amke; Spinner, Christoph D.; Classen, Annika Y.; Pilgram, Lisa; Ruethrich, Maria M.; Rupp, Jan; Nunes de Miranda, Susana M.; Römmele, Christoph; Vehreschild, Janne; Jensen, Bjoern-Erik; Vehreschild, Maria; Degenhardt, Christian; Borgmann, Stefan; Hower, Martin; Hanses, Frank; Haselberger, Martina; Friedrichs, Anette K.; the LEOSS-study group; Lanznaster, Julia
- Abstract
Purpose: Reported antibiotic use in coronavirus disease 2019 (COVID-19) is far higher than the actual rate of reported bacterial co- and superinfection. A better understanding of antibiotic therapy in COVID-19 is necessary. Methods: 6457 SARS-CoV-2-infected cases, documented from March 18, 2020, until February 16, 2021, in the LEOSS cohort were analyzed. As primary endpoint, the correlation between any antibiotic treatment and all-cause mortality/progression to the next more advanced phase of disease was calculated for adult patients in the complicated phase of disease and procalcitonin (PCT) ≤ 0.5 ng/ml. The analysis took the confounders gender, age, and comorbidities into account. Results: Three thousand, six hundred twenty-seven cases matched all inclusion criteria for analyses. For the primary endpoint, antibiotic treatment was not correlated with lower all-cause mortality or progression to the next more advanced (critical) phase (n = 996) (both p > 0.05). For the secondary endpoints, patients in the uncomplicated phase (n = 1195), regardless of PCT level, had no lower all-cause mortality and did not progress less to the next more advanced (complicated) phase when treated with antibiotics (p > 0.05). Patients in the complicated phase with PCT > 0.5 ng/ml and antibiotic treatment (n = 286) had a significantly increased all-cause mortality (p = 0.029) but no significantly different probability of progression to the critical phase (p > 0.05). Conclusion: In this cohort, antibiotics in SARS-CoV-2-infected patients were not associated with positive effects on all-cause mortality or disease progression. Additional studies are needed. Advice of local antibiotic stewardship- (ABS-) teams and local educational campaigns should be sought to improve rational antibiotic use in COVID-19 patients.
- Subjects
ANTIBIOTICS; DISEASE progression; CAUSES of death; COVID-19; AGE distribution; CALCITONIN; SEX distribution; LONGITUDINAL method; COMORBIDITY; PROBABILITY theory
- Publication
Infection, 2022, Vol 50, Issue 2, p423
- ISSN
0300-8126
- Publication type
Article
- DOI
10.1007/s15010-021-01699-2