Michał Makowiecki

Michał Makowiecki


Research Focus & Metrics

Academic Career Length

3Years (2024-Present)

(Calculated once Scilit publication data is synced: current year − year of first publication + 1)

Representative Publications

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23 December 2024 in Journal of Clinical Medicine
Verified
Journal Article
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MMMichał Makowiecki
Michał Makowiecki
MPMarcin Paciorek
Marcin Paciorek
ABAgnieszka Bednarska
Agnieszka Bednarska
DKDominika Krogulec
Dominika Krogulec
DPDawid Porowski
Dawid Porowski
TLTomasz Laskus
Tomasz Laskus
Background/Objectives: The aim of this study was to evaluate the association between various clinical and laboratory findings and in-hospital mortality in community-acquired bacterial meningitis (BM). Methods: We retrospectively analyzed 339 adult (≥18 years old) patients with bacterial meningitis who were admitted to the Hospital for Infectious Diseases in Warsaw between January 2010 and December 2017. Results: Altogether, 56 patients (16.5%) died during hospitalization. On admission, the non-survivors scored lower on the Glasgow Coma Scale (GCS) (median 7 vs. 13, p < 0.001) and higher on the Sequential Organ Failure Assessment (SOFA) score (median 6 vs. 2, p < 0.001) and were less likely to complain about headaches (18.75% vs. 54.21%, p < 0.001) and nausea and/or vomiting (1.89% vs. 36.2%, p < 0.001), but were more likely to manifest peripheral nerve palsies (21.43% vs. 9.61%, p = 0.02). The patients who died were also more likely to be immunocompromised (53.57% vs. 34.28%, p = 0.01), have Streptococcus pneumoniae etiology (35.71% vs. 16.25%, p = 0.001), higher concentrations of procalcitonin (median 5.035 ng/mL vs. 2.245 ng/mL, p = 0.003) and urea (median 10.7 mmol/L vs. 5.865 mmol/L, p < 0.001) in the blood and higher protein (median 4.57 g/L vs. 2.605 g/L, p = 0.014) and lower glucose levels (median 0.765 mmol/L vs. 1.89 mmol/L, p = 0.006) in the cerebrospinal fluid (CSF). In a multiple logistic regression analysis, which was conducted separately for the GCS and SOFA, both scoring systems (OR = 0.67, OR 95% CI 0.59–0.75, p < 0.001 for GCS and OR = 1.42, OR 95% CI 1.29–1.60, p < 0.001 for SOFA) as well as an age over 70 years (OR = 3.99, OR 95% CI 1.39–12.93, p = 0.014) and Streptococcus pneumoniae etiology (OR = 2.38, OR 95% CI 1.12–4.99, p = 0.022) were associated with in-hospital deaths. Conclusions: The survivors and non-survivors with BM differed with respect to a number of signs and symptoms, etiology, the results of blood and CSF laboratory tests, and the immune deficiency status, as well as the GCS and SOFA scores. In the multiple logistic regression analysis, both of the GCS and SOFA scoring systems, age and Streptococcus pneumoniae etiology showed high associations with the in-hospital deaths.

Verified
Journal Article
Open access
PDF file
ABAgnieszka Bednarska
Agnieszka Bednarska
MRMieczyslaw Radkowski
Mieczyslaw Radkowski
TLTomasz Laskus
Tomasz Laskus
AFAnna Furman-Dłubała
Anna Furman-Dłubała
MMMichał Makowiecki
Michał Makowiecki
MPMarcin Paciorek
Marcin Paciorek
Background/Objectives: Secondary bacterial infections in subjects hospitalized with COVID-19 are associated with longer hospital stays and an increased risk of death. Thus, identifying the risk factors associated with bacterial complications in patients with SARS-CoV-2 infection is clinically important. Methods: We analysed the collected records of all adult patients diagnosed with an acute COVID-19 infection who were admitted to the Hospital for Infectious Diseases in Warsaw, Poland, between March 2020 and November 2021. Logistic regression models were used to identify factors associated with bacterial infections complicating the SARS-CoV-2 course. Results: The records of 1963 patients were analysed; 1128 (57.4%) of the patients were male, the median age of the cohort was 63 years (IQR: 50–74 years), and 202 patients (10%) died. A bacterial infection complicating the course of COVID-19 was diagnosed in 351 (18%) patients. In a multivariate logistic regression model the only factors identified as independently associated with an increased odds of bacterial infection were age (OR per decade: 1.21, p = 0.016), length of hospitalization (OR per day: 1.12, p < 0.001), and D-dimer concentration (OR per 500 units: 1.01, p = 0.048). Conclusions: Shortening the length of hospitalization of patients with COVID-19 can reduce the risk of bacterial infection complications, especially in elderly individuals. Coagulation system activation in COVID-19 patients increases the risk of a bacterial infection.