Risk factors for healthcare-associated infection among patients hospitalized with COVID-19 infection

Introduction The occurrence of healthcare-associated infections (HAIs) increased during the coronavirus disease 2019 (COVID-19) pandemic,1–3 with the most substantial increase for central line-associated bloodstream infection (CLABSI), and methicillin-resistant Staphylococcus aureus (MRSA) bacteremia,4,5 reversing a multi-decade national trend of decreasing occurrence of these infections and leading to speculation that infection prevention practices had degraded as a result of the pandemic. Identified risk factors (Table 1) included higher comorbidity score on admission, longer LOS, admission to ICU, ventilator support, use of steroids, use of other immunosuppressive agents, and race/ethnicity. Because of the correlation between high-dose steroid use and lower age, an interaction term was included. Logistic regression for odds of HAI in patients with COVID-19 MRSA CLABSI Adjusted OR 95% CI Adjusted OR 95% CI ICU within 3 days of admission 1.41 (1.08, 1.84) 1.12 (0.92, 1.36) Mechanical ventilation within 3 days of admission 1.78 (1.30, 2.45) 1.75 (1.44, 2.13) Length of stay (days, before HAI) 1.01 (1.01, 1.01) 1.00 (1.00, 1.01) Tocilizumab or baricitinib (before HAI) 1.92 (1.43, 2.58) 1.76 (1.45, 2.13) Dexamethasone