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Record W4390794348 · doi:10.4212/cjhp.3398

Characterization of Coinfections in Patients with COVID-19

2024· article· en· W4390794348 on OpenAlexaffvenueabout
Alexander Pai, Zahra Kanji, James Joshua Douglas

Bibliographic record

VenueThe Canadian Journal of Hospital Pharmacy · 2024
Typearticle
Languageen
FieldImmunology and Microbiology
TopicAntibiotic Use and Resistance
Canadian institutionsLions Gate HospitalUniversity of British ColumbiaVancouver General Hospital
Fundersnot available
KeywordsCoinfectionMedicineAntibioticsMedical recordCoronavirus disease 2019 (COVID-19)Intensive care unitMechanical ventilationGynecologyInternal medicinePediatricsHuman immunodeficiency virus (HIV)VirologyInfectious disease (medical specialty)Disease

Abstract

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Background: Little is known about coinfections in patients with COVID-19, with antibiotics often initiated empirically. Objectives: To determine the rates and characteristics of early and late coinfections in COVID-19 patients and to characterize the use of anti-infective agents, especially antibiotics. Methods: This retrospective chart review involved patients with COVID-19 who were admitted to Lions Gate Hospital (Vancouver, British Columbia) between January 1 and June 30, 2020. Data were extracted from electronic medical records, and descriptive statistics were used to analyze the data. Results: Of the 48 patients admitted during the study period, 10 (21%) were determined to have coinfections: 3 (6%) had early coinfections and 7 (15%) had late coinfections. Early empiric use of antibiotics was observed in 32 (67%) patients; for 29 (91%) of these 32 patients, the therapy was deemed inappropriate. Patients with coinfections had longer hospital stays and more complications. Conclusions: Despite low rates of early coinfection, empiric antibiotics were started for a majority of the patients. Most late coinfections occurred in patients in the intensive care unit who required mechanical ventilation. Patients with coinfections had poorer outcomes than those without coinfections. RÉSUMÉ Contexte : On sait peu de choses sur les co-infections chez les patients atteints de COVID-19, les médicaments antibiotiques étant souvent initiés de manière empirique.Objectifs : Déterminer les taux et les caractéristiques des co-infections précoces et tardives chez les patients atteints de COVID-19 et caractériser l’utilisation d’anti-infectieux, en particulier les antibiotiques. Méthodes : Cet examen rétrospectif des dossiers portait sur des patients atteints de COVID-19 qui ont été admis à l’hôpital Lions Gate, à Vancouver (Colombie-Britannique), entre le 1er janvier et le 30 juin 2020. Les données ont été extraites des dossiers médicaux électroniques et des statistiques descriptives ont été utilisées pour analyser les données. Résultats : Sur les 48 patients admis au cours de la période d’étude, 10 patients (21 %) présentaient des co-infections : 3 patients (6 %) avaient des co-infections précoces et 7 (15 %), des co-infections tardives. Une utilisation empirique précoce d’antibiotiques a été observée chez 32 patients (67 %); pour 29 de ces 32 patients (91 %), le traitement a été jugé inapproprié. Les séjours à l’hôpital des patients co-infectés étaient plus longs et ils présentaient davantage de complications. Conclusions : Malgré de faibles taux de co-infection précoce, des antibiotiques empiriques ont été instaurés pour la majorité des patients. La plupart des co-infections tardives sont survenues chez des patients de l’unité de soins intensifs nécessitant une ventilation mécanique. Les résultats des patients avec co-infections étaient moins bons que ceux sans co-infections.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.005
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.004
Threshold uncertainty score0.007

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0010.005
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0020.002
Science and technology studies0.0010.001
Scholarly communication0.0010.001
Open science0.0000.001
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0020.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.008
GPT teacher head0.237
Teacher spread0.229 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

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Citations0
Published2024
Admission routes3
Has abstractyes

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Same venueThe Canadian Journal of Hospital PharmacySame topicAntibiotic Use and ResistanceFrench-language works237,207