Chang Xiaoxia, Lai Yanjun, Zhao Yingying, Zhao Jing, Zhang Yunchao, Qian Xiaotao, Zhang Guochao
Department of Clinical Laboratory, Ninth Hospital of Xi'an, Xi'an, Shannxi, China.
Department of Pathology, Fenyang College of Shanxi Medical University, Fenyang, Shanxi, China.
Front Immunol. 2025 Feb 19;16:1522313. doi: 10.3389/fimmu.2025.1522313. eCollection 2025.
Severe COVID-19 infection is characterized by excessive inflammatory responses, hypercoagulation, and microvascular dysfunction. However, limited research has investigated the effects of co-infections on these characteristics in COVID-19 patients. This study aims to explore how co-infections influence inflammation, hypercoagulability, and microvascular dysfunction in hospitalized COVID-19 patients, and to assess their impact on disease progression.
This was a retrospective cohort study involving 630 COVID-19 inpatients who tested positive for SARS-CoV-2 RNA at Xi'an Ninth Hospital. The patients were categorized into two groups: a severe group (n = 176) and a mild group (n = 454). Additionally, they were further subdivided into a co-infected (n = 106) group and a non-co-infected group (n=524) based on the presence or absence of co-infections. Clinical characteristics and laboratory findings were analyzed and compared between the groups.
In the co-infected group, 60 patients (56.6%) were classified as severe cases, and 15 (14.2%) died. By comparison, in the non-co-infected group, 97 patients (18.5%) were severe cases, with 4 (0.8%) deaths. The severity and mortality rates were significantly higher in co-infected patients compared to those non-co-infections. The severe and co-infected groups exhibited significantly higher levels of inflammatory cells, inflammatory factors, coagulation biomarkers, and myocardial injury markers compared to the mild and non-co-infected groups. Conversely, lymphocyte counts, RBC counts, HGB, HCT, TP, and ALB levels were significantly lower in the severe and co-infected groups than in the mild and non-co-infected groups. Furthermore, a notable positive correlation was observed among inflammatory factors, coagulation function, and myocardial injury biomarkers in COVID-19 patients.
Co-infections in COVID-19 patients can trigger severe inflammatory responses. This excessive inflammation may lead to coagulation disorders and myocardial injury, all of which are key contributors to disease progression and deterioration. Therefore, implementing infection prevention measures to minimize the spread of co-infections among hospitalized COVID-19 patients is crucial.
重症新型冠状病毒肺炎（COVID-19）感染的特征为过度炎症反应、高凝状态和微血管功能障碍。然而，关于合并感染对COVID-19患者这些特征的影响的研究有限。本研究旨在探讨合并感染如何影响住院COVID-19患者的炎症、高凝状态和微血管功能障碍，并评估其对疾病进展的影响。
这是一项回顾性队列研究，纳入了西安市第九医院630例SARS-CoV-2 RNA检测呈阳性的COVID-19住院患者。患者分为两组：重症组（n = 176）和轻症组（n = 454）。此外，根据是否存在合并感染，将他们进一步细分为合并感染组（n = 106）和非合并感染组（n = 524）。分析并比较两组患者的临床特征和实验室检查结果。
在合并感染组中，60例患者（56.6%）被归类为重症病例，15例（14.2%）死亡。相比之下，在非合并感染组中，97例患者（18.5%）为重症病例，4例（0.8%）死亡。合并感染患者的严重程度和死亡率显著高于非合并感染患者。与轻症和非合并感染组相比，重症和合并感染组的炎症细胞、炎症因子、凝血生物标志物和心肌损伤标志物水平显著更高。相反，重症和合并感染组的淋巴细胞计数、红细胞计数、血红蛋白、血细胞比容、总蛋白和白蛋白水平显著低于轻症和非合并感染组。此外，在COVID-19患者中，炎症因子、凝血功能和心肌损伤生物标志物之间存在显著的正相关。
COVID-19患者的合并感染可引发严重的炎症反应。这种过度炎症可能导致凝血障碍和心肌损伤，所有这些都是疾病进展和恶化的关键因素。因此，实施感染预防措施以尽量减少住院COVID-19患者中合并感染的传播至关重要。
