Background: Intensive care unit (ICU) patients with coronavirus disease 2019 (COVID-19), have a high risk of developing bloodstream infections (BSIs). However, the characteristics of and risk factors for BSIs in these patients remain unclear. Objective: We aimed to identify prevalent causative pathogens of BSI and related factors in critically ill patients with COVID-19. Design: This was a single-center, retrospective cohort study. Methods: We analyzed the clinical characteristics and outcomes of 201 ICU patients with COVID-19. Logistic regression analysis was conducted to identify factors associated with BSI occurrence. Furthermore, we identified the primary causative pathogens of BSIs. The study outcomes were death or ICU discharge. Results: Among the 201 included patients, 43 (21.4%) patients developed BSI. The mortality rate was non-significantly higher in the BSI group than in the BSI group (65.1% versus 58.9%, p = 0.487). There were significant between-group differences in the obesity prevalence and sex distribution, but not corticosteroid usage. BSI occurrence was significantly associated with duration of mechanical ventilation (MV), presence of ventilator-associated pneumonia, use of neuromuscular blocking agents, length of stay in ICU (ICU LOS), high body mass index (BMI), and male sex. The main causative pathogens were Klebsiella pneumoniae, Acinetobacter baumannii, and Enterococcus faecalis. Multi-drug-resistant pathogens were found in 87% of cases. Regardless of the origin, the common risk factors for BSI were ICU LOS and MV duration. All BSIs were acquired within the hospital setting, with ≈60% of the cases being primary BSIs. A small proportion of the BSI cases were catheter-related (four cases, 6.2%). Ventilator-associated pneumonia and urinary tract infections were present in 25% and 9.4% of the BSI cases, respectively. On average, the first positive blood culture appeared ≈11.4 (±9.7) days after ICU admission. Conclusion: Elucidating the risk factors for and common pathogens of BSI can inform prompt management and prevention of BSIs.

Background: Catheter-associated urinary tract infections (CA-UTIs) pose a significant challenge in intensive care unit (ICU) patients with COVID-19. Objective: The study aims to assess the prevalence of CA-UTIs, identify the causative pathogens and their resistance profiles, and determine the risk factors and outcomes associated with CA-UTIs in ICU patients with COVID-19. Design: Single-center, retrospective cohort study. Methods: The study included 201 adult ICU patients diagnosed with COVID-19 between March 2020 and July 2021. Patients were categorized into CA-UTI ( n = 56) and non-CA-UTI ( n = 145) groups. Data on demographic characteristics, clinical course, treatment, and outcomes were collected. Logistic regression analysis was used to identify risk factors for CA-UTI. Results: CA-UTIs developed in 28% of patients ( n = 56). Incidence density of 15.8 episodes per 1000 catheter days. The average onset occurrence is 7.2 days after ICU admission. Patients with CA-UTI had longer ICU stays (18.8 days vs 10.5 days, p < 0.001) and more elevated mortality rates (75.0% vs 54.5%, p = 0.010), higher mechanical ventilation (MV) usage (98.2% vs 88.3%, p = 0.027), a longer average duration of MV (16.6 days vs 9.1 days, p < 0.001). Longer ICU and hospital stays were significant risk factors for CA-UTI. Other factors, such as the use of corticosteroids, chronic organ insufficiency or immunocompromized status, female sex, age, diabetes mellitus, and the duration of urinary catheterization, did not show significant associations with CA-UTI risk in this cohort. Gram-negative bacteria, particularly Klebsiella pneumoniae (28 cases), was the most common pathogen, with a high prevalence of multidrug resistance (38.8%) with type ESBL, MBL, NDM, and OXA-48. The occurrence of multidrug resistant (MDR) organisms was 68.8%. Conclusion: The findings of this study underscore the prevalence of CA-UTIs in ICU patients with COVID-19, significantly impacting patient outcomes. Effective infection control and targeted antimicrobial therapy are crucial to managing these infections.

The Coronavirus Disease 2019 (COVID-19) has caused a global health crisis. Mortality predictors in critically ill patients remain under investigation. A retrospective cohort study included 201 patients admitted to the intensive care unit (ICU) due to COVID-19. Data on demographic characteristics, laboratory findings, and mortality were collected. Logistic regression analysis was conducted with various independent variables, including demographic characteristics, clinical factors, and treatment methods. The study aimed to identify key risk factors associated with mortality in an ICU. In an investigation of 201 patients comprising non-survivors (n = 80, 40%) and Survivors (n = 121, 60%), we identified several markers significantly associated with ICU mortality. Lower Interleukin 6 and White Blood Cells levels at both 24- and 48-hours post-ICU admission emerged as significant indicators of survival. The study employed logistic regression analysis to evaluate risk factors for in-ICU mortality. Analysis results revealed that demographic and clinical factors, including gender, age, and comorbidities, were not significant predictors of in-ICU mortality. Ventilator-associated pneumonia was significantly higher in Survivors, and the use of antibiotics showed a significant association with increased mortality risk in the multivariate model (OR: 11.2, p = 0.031). Our study underscores the significance of monitoring Il-6 and WBC levels within 48 hours of ICU admission, potentially influencing COVID-19 patient outcomes. These insights may reshape therapeutic strategies and ICU protocols for critically ill patients.

Coronavirus disease 2019 (COVID-19) placed substantial pressure on intensive care units (ICUs), but long-period comparisons with non-COVID-19 ICU patients

Background/Objectives: The association of body mass index (BMI) with outcomes after intensive care unit (ICU) admission remains uncertain. We examined ICU mortality and early biomarker patterns in adults with COVID-19. Methods: This single-center retrospective secondary analysis included 201 patients. BMI was analyzed per 5 kg/m² using logistic regression for mortality and generalized estimating equations for biomarkers, adjusted for age, sex, and calendar time. Six inflammatory and coagulation biomarkers were averaged within four consecutive 24 h intervals covering the first 96 h after ICU admission. False-discovery-rate correction and missingness sensitivity analyses were performed. Results: Eighty patients died (39.8%). The adjusted mortality odds ratio was 1.02 (95% CI 0.82–1.26). Joint tests of interval-specific BMI associations were significant for interleukin-6 (IL-6) and white blood cell count, but not the other four biomarkers under the primary specification. Only IL-6 at 24–48 h remained significant after correction across 24 contrasts (−35.9% per 5 kg/m² higher BMI; 95% CI −49.4 to −18.8; q = 0.006), based on 40/201 patients. Conclusions: Within this selected ICU cohort, BMI showed no clear adjusted mortality association and biomarker findings were heterogeneous. The isolated inverse IL-6 association remains exploratory because of sparse measurements and potentially informative missingness and requires independent confirmation with standardized sampling.

Background/Objectives: Intensive care unit (ICU) mortality reflects interactions between baseline vulnerability, acute physiological derangement, ICU-acquired infection, and the intensity of organ-support therapy. Methods: This single-center retrospective cohort study included 3323 adult first ICU hospitalizations at the University Clinical Hospital in Bialystok, Poland, between 1 January 2017 and 1 June 2023. Secondary ICU admissions/readmissions, patients aged <18 years, and one pregnancy admission were excluded. Patients were classified as ICU survivors (n = 1778) or ICU non-survivors (n = 1545). Variables were compared using t-tests, chi-square tests, or Fisher exact tests, and an adjusted logistic regression model was fitted as an exploratory prognostic model. Results: ICU mortality was 46.5%, and 28-day ICU mortality was 40.2%. Non-survivors were older than survivors (66.7 ± 15.1 vs. 60.9 ± 17.2 years; p < 0.001) and more frequently had arterial hypertension, diabetes mellitus, COVID-19, ischemic heart disease, atrial fibrillation, renal failure, and acute myocardial infarction or ischemic stroke. In the adjusted model, ICU mortality was associated with age per 10 years (OR 1.32, 95% CI 1.18–1.47), COVID-19 (OR 3.15, 95% CI 2.07–4.79), ventilator-associated pneumonia (OR 1.68, 95% CI 1.22–2.30), lactate per 1 mmol/L (OR 1.29, 95% CI 1.16–1.43), pH per 0.1-unit decrease (OR 1.79, 95% CI 1.41–2.29), mechanical ventilation (OR 14.74, 95% CI 3.40–63.87), cardiopulmonary resuscitation (OR 9.45, 95% CI 4.67–19.13), renal replacement therapy (OR 2.01, 95% CI 1.39–2.91), and treatment of acidosis or alkalosis (OR 1.95, 95% CI 1.29–2.94). Conclusions: ICU non-survival was associated with older age, COVID-19, cardiovascular and renal vulnerability, ICU-acquired infection, inflammatory and metabolic dysfunction, and early requirement for rescue organ-support interventions. These findings should be interpreted as adjusted associations, not causal effects.