Universität zu Köln

Schons, Maximilian J., Caliebe, Amke, Spinner, Christoph D., Classen, Annika Y., Pilgram, Lisa, Ruethrich, Maria M., Rupp, Jan ORCID: 0000-0001-8722-1233, de Miranda, Susana Nunes, Rommele, Christoph ORCID: 0000-0002-8745-8510, Vehreschild, Janne, Jensen, Bjoern-Erik, Vehreschild, Maria, Degenhardt, Christian, Borgmann, Stefan, Hower, Martin, Hanses, Frank ORCID: 0000-0002-0007-8014, Haselberger, Martina and Friedrichs, Anette K. (2022). All-cause mortality and disease progression in SARS-CoV-2-infected patients with or without antibiotic therapy: an analysis of the LEOSS cohort. Infection, 50 (2). S. 423 - 437. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1439-0973

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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.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Schons, Maximilian J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Caliebe, Amke UNSPECIFIED UNSPECIFIED UNSPECIFIED Spinner, Christoph D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Classen, Annika Y. UNSPECIFIED UNSPECIFIED UNSPECIFIED Pilgram, Lisa UNSPECIFIED UNSPECIFIED UNSPECIFIED Ruethrich, Maria M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Rupp, Jan UNSPECIFIED orcid.org/0000-0001-8722-1233 UNSPECIFIED de Miranda, Susana Nunes UNSPECIFIED UNSPECIFIED UNSPECIFIED Rommele, Christoph UNSPECIFIED orcid.org/0000-0002-8745-8510 UNSPECIFIED Vehreschild, Janne UNSPECIFIED UNSPECIFIED UNSPECIFIED Jensen, Bjoern-Erik UNSPECIFIED UNSPECIFIED UNSPECIFIED Vehreschild, Maria UNSPECIFIED UNSPECIFIED UNSPECIFIED Degenhardt, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Borgmann, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED Hower, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Hanses, Frank UNSPECIFIED orcid.org/0000-0002-0007-8014 UNSPECIFIED Haselberger, Martina UNSPECIFIED UNSPECIFIED UNSPECIFIED Friedrichs, Anette K. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-602158
DOI:	10.1007/s15010-021-01699-2
Journal or Publication Title:	Infection
Volume:	50
Number:	2
Page Range:	S. 423 - 437
Date:	2022
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1439-0973
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CHARLSON COMORBIDITY INDEX; COVID-19; PROCALCITONIN; PNEUMONIA Multiple languages Infectious Diseases Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/60215