Effectiveness of Streptococcus Pneumoniae Urinary Antigen Testing in Decreasing Mortality of COVID-19 Co-Infected Patients: A Clinical Investigation

被引：14

作者：

Desai, Antonio ^{[1
,2
]}

Santonocito, Orazio Giuseppe ^{[3
]}

Caltagirone, Giuseppe ^{[1
,2
]}

Kogan, Maria ^{[1
]}

Ghetti, Federica ^{[1
]}

Donadoni, Ilaria ^{[1
]}

Porro, Francesca ^{[1
]}

Savevski, Victor ^{[4
]}

Poretti, Dario ^{[3
]}

Ciccarelli, Michele ^{[5
]}

Martinelli Boneschi, Filippo ^{[6
,7
,8
]}

Voza, Antonio ^{[1
]}

机构：

[1] IRCCS, Humanitas Clin & Res Ctr, Emergency Dept, I-20089 Milan, Italy

[2] Humanitas Univ, Dept Biomed Sci, I-20090 Pieve Emanuele, Italy

[3] IRCCS, Humanitas Clin & Res Ctr, Dept Diagnost & Intervent Radiol, I-20089 Milan, Italy

[4] IRCCS, Humanitas Clin & Res Ctr, Artificial Intelligence Ctr, I-20089 Milan, Italy

[5] IRCCS, Humanitas Clin & Res Ctr, Pneumol Dept, I-20089 Milan, Italy

[6] Univ Milan, Dept Pathophysiol & Transplantat DEPT, Neurosci Sect, Dino Ferrari Ctr, I-20122 Milan, Italy

[7] Fdn IRCCS Ca Granda Osped Maggiore Policlin, Neurol Unit, I-20122 Milan, Italy

[8] Fdn IRCCS Ca Granda Osped Maggiore Policlin, MS Ctr, I-20122 Milan, Italy

来源：

MEDICINA-LITHUANIA | 2020年 / 56卷 / 11期

关键词：

antibodies; bacterial infection 2; COVID-19; SARS-CoV-2; Streptococcus pneumoniae; COMMUNITY-ACQUIRED PNEUMONIA; RESPIRATORY PATHOGENS; BACTERIAL COINFECTION; INFLUENZA; DIAGNOSIS; EPIDEMIOLOGY; COMPLICATION; ADULTS; ASSAY; BINAX;

D O I：

10.3390/medicina56110572

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background and objectives: Streptococcus pneumoniae urinary antigen (u-Ag) testing has recently gained attention in the early diagnosis of severe and critical acute respiratory syndrome coronavirus-2/pneumococcal co-infection. The aim of this study is to assess the effectiveness of Streptococcus pneumoniae u-Ag testing in coronavirus disease 2019 (COVID-19) patients, in order to assess whether pneumococcal co-infection is associated with different mortality rate and hospital stay in these patients. Materials and Methods: Charts, protocols, mortality, and hospitalization data of a consecutive series of COVID-19 patients admitted to a tertiary hospital in northern Italy during COVID-19 outbreak were retrospectively reviewed. All patients underwent Streptococcus pneumoniae u-Ag testing to detect an underlying pneumococcal co-infection. Covid19+/u-Ag+ and Covid19+/u-Ag- patients were compared in terms of overall survival and length of hospital stay using chi-square test and survival analysis. Results: Out of 575 patients with documented pneumonia, 13% screened positive for the u-Ag test. All u-Ag+ patients underwent treatment with Ceftriaxone and Azithromycin or Levofloxacin. Lopinavir/Ritonavir or Darunavir/Cobicistat were added in 44 patients, and hydroxychloroquine and low-molecular-weight heparin (LMWH) in 47 and 33 patients, respectively. All u-Ag+ patients were hospitalized. Mortality was 15.4% and 25.9% in u-Ag+ and u-Ag- patients, respectively (p = 0.09). Survival analysis showed a better prognosis, albeit not significant, in u-Ag+ patients. Median hospital stay did not differ among groups (10 vs. 9 days, p = 0.71). Conclusions: The routine use of Streptococcus pneumoniae u-Ag testing helped to better target antibiotic therapy with a final trend of reduction in mortality of u-Ag+ COVID-19 patients having a concomitant pneumococcal infection. Randomized trials on larger cohorts are necessary in order to draw definitive conclusion.

引用

页码：1 / 10

页数：10

共 52 条

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