Bacterial infections found in higher-risk, hospitalized COVID-19 patients
Half of 399 hospitalized COVID-19 patients developed bacterial infections 48 or more hours after hospitalization, according to a PLOS One study yesterday. The bacterial superinfections were associated most strongly with lung disease, encephalopathy, mechanical ventilation, hospital stay of 8 or more days, and steroid treatment.
From March to August 2020, the researchers looked at hospitalized COVID-19 patients at two clinics in Medellín, Colombia, who had at least one of the following risk factors: age over 60 years, diabetes, heart disease, lung disease, immunosuppression, or poor prognostic factors (eg, low white blood cells). The cohort consisted of 58.9% men, and 41.9% of the total was over 59 years. The most common comorbidities were high blood pressure (41.6%), diabetes (23.8%), obesity (15.0%), and hypothyroidism (13%).
Overall, 198 (49.6%) had bacterial superinfections, which had to meet clinical, paraclinical, and radiologic criteria. Sixteen species were identified, the most common being Klebsiella (pneumoniae and oxytoca) and Staphylococcus aureus. Most patients received antibiotics for 1 week (62.7%, 60.3% as monotherapy). Ampicillin/sulbactam was the most common treatment (56.4%), but other frequent antibiotics were piperacillin/tazobactam (29.9%), meropenem (18.6%), ciprofloxacin (16.7%), and ceftriaxone (15.2%).
During hospitalization, 28.8% of patients were admitted to the intensive care unit, 26.6% needed mechanical ventilation, 20.8% suffered kidney failure, and 10.5% died. The researchers found no fungal superinfections.
Data showed that bacterial superinfection was 36% higher in those 60 and above, 42% higher in those with chronic lung disease, 58% higher in those who were immunosuppressed, and 38% higher in those with acute renal failure. After multivariate adjustment, associations with bacterial superinfection were lung disease, encephalopathy, mechanical ventilation, hospital stay of 8 or more days, and steroid treatment.
"These results are vital to identifying priority clinical groups, improving the care of simultaneous infections with COVID-19 in people with the risk factors exposed in the population studied, and identifying bacteria of public health interest," the researchers write.
Jul 13 PLOS One study
Study finds well-being gap between remote, in-person high school learning
High school students taking remote classes had lower social, emotional, and academic well-being survey scores compared with high schoolers who attended in person during the pandemic, according to an Educational Researcher study yesterday.
The researchers had given a 10-question survey to 6,576 high schoolers enrolled at Orange County public schools in Florida. Students first took the survey in February 2020 when they were in grades 8 through 11, and later the same students, then in 9th to 12th grade, took the survey in October 2020. The second survey occurred 1 to 2 months after 63.9% had chosen to continue remote learning for the 2020-21 school year and the remainder had chosen to attend in person.
The survey was scored on a 100-point scale, and in-person students had higher scores in all three categories, with the largest difference in social well-being (77.2 vs 74.8), compared with emotional (57.4 vs 55.7) and academic (78.4 vs 77.3) well-being. The well-being gap was notably larger among 10th through 12th graders versus 9th graders, although the gap was present across gender, race/ethnicity, and socioeconomic status.
The researchers note that students who attended school in person were more likely male, White, in the ninth grade, ineligible for free or reduced-price meals, or from an English-speaking home. Although they were also more likely to have lower grades, they had a higher probability of having better social well-being.
"As policymakers gear up for national tutoring and remediation programs—which we agree are urgent priorities—we must recognize that our nation's students are not just lagging as performers, they are suffering as people," said lead author Angela L. Duckworth, PhD, MSc, MA, in an American Educational Research Association (AERA) press release. "Meeting their intrinsic psychological needs—for social connection, for positive emotion, and authentic intellectual engagement—is a challenge that cannot wait."
Jul 13 Edu Research study
Jul 14 AERA press release