Predictors and Outcomes of HAIs in COVID-19 Patients.

INTRODUCTION Healthcare Associated infections (HAI) after a viral illness are important source of morbidity and mortality, this has not been studied well in hospitalized COVID-19 patients. METHODS We included all COVID-19 positive adult patients (≥18 years) hospitalized between March 1, 2020 to August 5th, 2020. We used CDC definitions of HAI in the acute care setting. Outcomes studied were rates and types of infections and in hospital mortality.. We constructed several multivariable logistic regression models to examine characteristics associated with development of HAI. RESULTS Of 1565 patients, 140 separate HAIs from 73 different organisms developed in 59 (3.7%) patients. Of these, 23 were gram positive, 39 were gram negative and 11 were fungal. Patient developing HAI did not have higher odds of death (OR 0.85,95%CI 0.40-1.81, p = 0.69). HAIs were associated with use of tocilizumab (OR 5.04, 95%CI 2.4-10.6, p < 0.001), steroids (OR 3.8, 95%CI 1.4-10, p = 0.007), hydroxychloroquine(OR 3.0, 95%CI 1.0-8.8, p = 0.05) and acute kidney injury requiring hemodialysis (OR 3.7, 95%CI 1.1-12.8, p = 0.04). CONCLUSIONS HAI are common in hospitalized covid-19 patients. Tocilizumab and steroids were associated with increased risk of HAIs.