Mustafa Zia Ul, Suleman Aneeqa, Masood Muhammad Faiq, Salman Muhammad, Nazir Aftab, Mallhi Tauqeer Hussain, Khan Yusra Habib, Mudenda Steward, Meyer Johanna C, Godman Brian, Seaton R Andrew
Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Gelugor, Malaysia.
Department of Pharmacy Services, District Headquarter (DHQ) Hospital, Pakpattan, Pakistan.
IJID Reg. 2024 Sep 7;13:100445. doi: 10.1016/j.ijregi.2024.100445. eCollection 2024 Dec.
Patients with COVID-19 admitted to intensive care units (ICUs) typically have many complications and co-morbidities, including secondary bacterial and fungal infections, which increase morbidity and mortality. The first step to address this is to measure the prevalence rates, predictors of fungal infections, and outcomes of patients with COVID-19 admitted to ICUs in Pakistan.
Retrospective review of medical records of patients admitted with COVID-19 to the ICUs of six tertiary care hospitals in Pakistan between March 2020 and June 2023.
A total of 636 patients were included; 68.9% were aged ≥50 years and 62.6% were male. Diabetes mellitus was the commonest co-morbidity (23.7%). A total of 67.8% of patients had severe COVID-19, with 23% critical cases. Antibiotics and antipyretics (all patients) were the most frequently prescribed medicines, along with corticosteroids (72.5%). A total of 63 nosocomial fungal infections developed in 53 patients, with mechanical ventilation and tracheal intubation being significant predictors of secondary fungal infections among patients with COVID-19. The mortality rate was 4.9%, with secondary fungal infections significantly associated with higher mortality.
Approximately 8% of patients with COVID-19 admitted to the ICUs of tertiary developed secondary fungal infections associated with greater mortality. The key factors associated with secondary fungal infections need to be carefully monitored to reduce future mortality in these patients. We will continue to monitor the situation.
入住重症监护病房（ICU）的新冠肺炎患者通常有许多并发症和合并症，包括继发性细菌和真菌感染，这会增加发病率和死亡率。解决这一问题的第一步是测量巴基斯坦入住ICU的新冠肺炎患者的真菌感染患病率、预测因素及预后情况。
回顾性分析2020年3月至2023年6月期间巴基斯坦6家三级护理医院ICU收治的新冠肺炎患者的病历。
共纳入636例患者；68.9%的患者年龄≥50岁，62.6%为男性。糖尿病是最常见的合并症（23.7%）。共有67.8%的患者患有重症新冠肺炎，其中23%为危重症病例。抗生素和解热药（所有患者）是最常开具的药物，其次是皮质类固醇（72.5%）。53例患者共发生63例医院获得性真菌感染，机械通气和气管插管是新冠肺炎患者继发性真菌感染的重要预测因素。死亡率为4.9%，继发性真菌感染与较高死亡率显著相关。
入住三级医院ICU的新冠肺炎患者中约8%发生继发性真菌感染，且死亡率更高。需要密切监测与继发性真菌感染相关的关键因素，以降低这些患者未来的死亡率。我们将继续监测这一情况。
