Bacterial coinfections are really rare in Covid-19 intensive care units?

Abstract Background: There are conflicting and limited data about nosocomial coinfections in COVID-19 case in the intensive care unit. This study aims to investigate coinfections in COVID-19 patients followed in a tertiary care reference university hospital intensive care unit. Methods: This study was conducted and analyzed retrospectively the data of coinfections of 351 COVID-19 patients in the period 28.02.2020–15.01.2021 in a tertiary care intensive care unit in a university hospital. Results: Bacterial coinfections were present in 216 of the 351 cases. One hundred and thirty of these cases were evaluated as nosocomial infections. Third day the Sequential Organ Failure Assessment Score, usage of invasive mechanical ventilation, and presence of septic shock were significantly higher in the coinfected group. The neutrophil/lymphocyte ratio, polymorphonuclear leukocyte count, procalcitonin, C reactive protein, ferritin, and blood urea nitrogen values were significantly higher in the coinfection group. In the multinomial regression analysis, the number of white blood cells (WBC) (HR: 1.063 [1.019–1.109], p: 0.005) and invasive mechanical ventilation use (HR: 3.336 [1.865–5.966], p < 0.001) were considered independent risk factors for coinfection. The rates of hospitalization on the day of arrival (p: 0.000) and the 21st day (p: 0.005), as well as total mortality (p: 0.004), were significantly higher in the coinfected group.Conclusions: Bacterial coinfections of COVID-19 patients in intensive care unit was not rare. Mortality in coinfected patients was higher than noninfected group. Identifying the infectious agent, classifying colonizations and infections, and using the proper treatment of antibiotics is of great importance in case management of COVID-19 patients in intensive care unit.