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Table 2 Epidemiology and outcomes of COBSI before and during SARS-CoV-2 periods by SARS-CoV-2 testing status

From: Epidemiology and outcomes of culture-positive bloodstream pathogens prior to and during the SARS-CoV-2 pandemic: a multicenter evaluation

 

July 2019-February 2020

March 2020–September 4, 2021

 

Pre-pandemic period

Pandemic period

Characteristics

 

SARS-CoV-2 + 

SARS-CoV-2 −

SARS-CoV-2 not tested

Total

 

20,113

1638

27,476

10,590

39,704

Unadjusted BSI rate per 1000 admissions

11.240

9.613c

15.818c

6.864c

11.508a

Mean age ± SD, (IQR; median)

65.1 ± 16.7 (55–78; 67)

66.2 ± 16.2 (56–79; 68)a

65.2 ± 16.3 (55–77; 67)

64.6 ± 16.6 (55–77; 67)a

65.2 ± 16.4 (55–77; 67)

Males, n (%)

10,467 (52.0)

843 (51.5)

14,751 (53.7)b

5560 (52.5)

21,154 (53.3%)a

Prior 30-day admission, (%)

13.2% (2655)

16.7% (274)c

14.4% (3945)c

14.9% (1581)c

14.6% (5800)c

Prior 90-day admission (%)

22.7% (4572)

27.2% (445)c

26.9% (7393)c

27.3% (2889)c

27.0% (10,727)c

 ≥1 Underlying conditionsd (%)

86.3% (17,356)

94.6% (1550)c

90.7% (24,932)c

83.9% (8889)c

89.1% (35,371)c

LOS (days): avg ± SD (IQR; median)

9.1 ± 8.3 (4–11; 7)

12.2 ± 11.8 (5–15; 9)c

9.2 ± 8.6 (4–11; 7)

8.3 ± 7.8 (4–10; 6)c

9.6 ± 8.6 (4–11; 7)

% Ventilatede (%)

4.7% (954)

10.7% (175)c

5.4% (1490)c

4.0% (424)a

5.3% (2089)b

ICU admission (%)

32.8% (6591)

36.6% (600)b

29.6% (8138)c

26.5% (2838)c

29.2% (11,576)c

Overall LOS (days):

avg ± SD (IQR; median)

12.1 ± 10.6 (6–15; 9)

15.5 ± 14.9 (6–20; 12)c

12.5 ± 11.7 (6–15, 9)

11.3 ± 10.7 (5–14; 8)c

12.3 ± 11.7 (5–15; 9)

ICU LOS (days):

avg ± SD (IQR; median)

4.7 ± 5.3 (2–6; 3)

6.5 ± 7.4 (2–8; 4)c

5.0 ± 6.8 (2–6; 3)a

4.6 ± 5.5 (1–6; 3)c

5 ± 6.6 (2–6; 3)b

Hospital mortality (%)

NA

20.7% (237/1,146)

7.0% (1324/18,843)

NA

7.8% (1567/20,064)

  1. aP < .05; bP < .01; cP < .001 bivariate correlations compared to the pre-SARS-CoV-2 period
  2. dIncludes the following baseline conditions occurring within the first 3 days of hospital admissions as determined by the maximum value of surrogate laboratory results: renal insufficiency (serum creatinine [SCr] > 2.0 mg/dL [to convert to micromoles per liter, multiply by 88.4]); kidney failure (blood urea nitrogen > 100 and SCr > 3.0 mg/dL); suspected sepsis (lactic acid > 2.0 or > 4.0 mmol/L); suspected heart failure (brain-type natriuretic peptide [BNP] > 400 pg/mL [to convert to nanograms per liter, multiply by 1.0] or N-terminal pro BNP > 900 pg/mL); myocardial inflammation (doubling of troponin drawn within 6 h final value: troponin 0.4 ng/L [to convert to micrograms per liter, multiply by 1.0], troponin T15 ng/L [to convert to micrograms per liter, multiply by 1.0] in male patients, troponin T10 ng/L in female patients, troponin I > 0.04 ng/mL [to convert to micrograms per liter, multiply by 1.0]); liver dysfunction (any of the following: alanine aminotransferase > 60 U/L [to convert to microkatals per liter, multiply by 0.0167], aspartate aminotransferase > 80 U/L [to convert to microkatals per liter, multiply by 0.0167], serum albumin < 3.0 g/dL [to convert to grams per liter, multiply by 10], international normalized ratio > 2.0 [and not currently receiving warfarin, rivaroxaban, apixaban, edoxaban, or betrixaban]); cytokine stimulation (any of the following: fibrinogen < 250 mg/dL [to convert to grams per liter, multiply by 0.01], C-reactive protein > 7.0 mg/dL [to convert to milligrams per liter, multiply by 10], D-dimer [dimerized plasmin fragment D] > 1000 ng/mL [to convert to nanomoles per liter, multiply by 5.476], erythrocyte sedimentation rate > 30 mm/h, or triglycerides > 265 mg/dL [to convert to millimoles per liter, multiply by 0.0113])
  3. eThe patient was (a) started on intravenous (IV)/IV push (IVP) sedation medications (propofol, lorazepam, midazolam, dexmedetomidine, or ketamine) or IV/IVP opioids (fentanyl, remifentanil, sufentanil, or hydromorphone) with a duration ≥ 24 h and (b) ≥ 2 arterial blood gas results collected ≥ 24 h apart (on the first day of sedation medication and a subsequent result 24 h later)