1. Co-infections and superinfections complicating COVID-19 in cancer patients: A multicentre, international study
- Author
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Belén Gutiérrez-Gutiérrez, F. Herrera, X. Durà-Miralles, C. Maluquer, Pilar Martín-Dávila, C.M. Ayaz, Lourdes Vázquez, G. Haidar, Luisa Sorlí, A. Silva-Pinto, Maddalena Peghin, M. Machado, P. Hernández-Jiménez, B. Kayaaslan, Ignacio Márquez-Gómez, F. Gabilán, Edson Abdala, J. Goikoetxea, J. Aguilar-Company, T.M. Andermann, Carlota Gudiol, Hugo Manuel Paz Morales, C. González-Rico, Natalia Pallares, Jordi Carratalà, S. Cuellar, Mercedes Marín, F. Fernandez-Avilés, Cristina Royo-Cebrecos, C. Salgueira, N. De Castro, M. Martínez-Cutillas, Manuela Aguilar-Guisado, Institut Català de la Salut, [Gudiol C] Department of Infectious Diseases, Biostatistics Unit, Bellvitge University Hospital, Bellvitge Institute for Biomedical Research (IDIBELL), University of Barcelona, Barcelona, Spain. Institut Català d’Oncologia, IDIBELL, University of Barcelona, Barcelona, Spain. Spainsh Network for Research in Infectious Diseases (REIPI), Instituto de Salud Carlos III, Madrid, Spain. [Durà-Miralles X] Department of Infectious Diseases, Biostatistics Unit, Bellvitge University Hospital, Bellvitge Institute for Biomedical Research (IDIBELL), University of Barcelona, Barcelona, Spain. Spainsh Network for Research in Infectious Diseases (REIPI), Instituto de Salud Carlos III, Madrid, Spain. [Aguilar-Company J] Servei d’Oncologia Mèdica, Servei de Malalties Infeccioses, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain. [Hernández-Jiménez P] Infectious Diseases Unit, 12 de Octubre University Hospital, Madrid, Spain. [Martínez-Cutillas M] Medical Oncology Department, Puerta de Hierro University Hospital, Madrid, Spain. [Fernandez-Avilés F] Bone Marrow Transplantation Unit, Department of Haematology, Hospital Clinic of Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus
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Microbiology (medical) ,medicine.medical_specialty ,Neutropenia ,medicine.disease_cause ,COVID-19 (Malaltia) ,Càncer - Complicacions ,Article ,law.invention ,neoplasias [ENFERMEDADES] ,Cohort Studies ,Otros calificadores::Otros calificadores::/complicaciones [Otros calificadores] ,law ,Internal medicine ,Neoplasms ,Streptococcus pneumoniae ,Epidemiology ,virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus [ENFERMEDADES] ,medicine ,Humans ,Opportunistic infections ,Virus Diseases::Coinfection [DISEASES] ,Respiratory tract infections ,business.industry ,Coinfection ,SARS-CoV-2 ,virosis::coinfección [ENFERMEDADES] ,Cancer ,COVID-19 ,Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections [DISEASES] ,Cancer patients ,medicine.disease ,Intensive care unit ,Neoplasms [DISEASES] ,Malalts de càncer ,Intensive Care Units ,Infectious Diseases ,Superinfection ,business ,Infeccions oportunistes ,Other subheadings::Other subheadings::/complications [Other subheadings] ,Cohort study - Abstract
Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Complicacions infeccioses; Càncer Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Complicaciones infecciosas; Cáncer Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Infectious complications; Cancer Background We aimed to describe the epidemiology, risk factors, and clinical outcomes of co-infections and superinfections in onco-hematological patients with COVID-19. Methods International, multicentre cohort study of cancer patients with COVID-19. All patients were included in the analysis of co-infections at diagnosis, while only patients admitted at least 48 h were included in the analysis of superinfections. Results 684 patients were included (384 with solid tumors and 300 with hematological malignancies). Co-infections and superinfections were documented in 7.8% (54/684) and 19.1% (113/590) of patients, respectively. Lower respiratory tract infections were the most frequent infectious complications, most often caused by Streptococcus pneumoniae and Pseudomonas aeruginosa . Only seven patients developed opportunistic infections. Compared to patients without infectious complications, those with infections had worse outcomes, with high rates of acute respiratory distress syndrome, intensive care unit (ICU) admission, and case-fatality rates. Neutropenia, ICU admission and high levels of C-reactive protein (CRP) were independent risk factors for infections. Conclusions Infectious complications in cancer patients with COVID-19 were lower than expected, affecting mainly neutropenic patients with high levels of CRP and/or ICU admission. The rate of opportunistic infections was unexpectedly low. The use of empiric antimicrobials in cancer patients with COVID-19 needs to be optimized. This study was supported by the Spanish Plan Nacional de IDi 2013-2016, Instituto de Salud Carlos III, Subdirección General de Redes y Centros de Investigación Cooperativa, Ministerio de Economía, Industria y Competitividad, and the Spanish Network for Research in Infectious Diseases (REIPI grant: RD16/0016/0001). It was also co-financed by the European Development Regional Fund ‘A Way to Make Europe’, Operational Programme Smart Growth 2014-2020.
- Published
- 2021