J Gastroenterol Hepatol. 2023 Jan 20. doi: 10.1111/jgh.16128. Online ahead of print.
ABSTRACT
INTRODUCTION: Clostridioides difficile infection (CDI) is the leading cause of hospital acquired-infectious diarrhea in the United States. In this study, we assess the prevalence and impact of CDI in COVID-19 hospitalizations in the United States.
METHODS: We used the 2020 National Inpatient Sample database to identify adult patients with COVID-19. The patients were stratified into two groups based on the presence of CDI. The impact of CDI on outcomes such as in-hospital mortality, ICU admission, shock, acute kidney injury (AKI), and sepsis rates. Multivariate regression analysis was performed to assess the effects of CDI on outcomes.
RESULTS: The study population comprised 1,581,585 patients with COVID-19. Among these, 0.65% of people had a CDI. There was a higher incidence of mortality in patients with COVID-19 and CDI compared to patients without COVID-19 (23.25% vs. 13.33%, p<0.001). The patients with COVID-19 and CDI had a higher incidence of sepsis (7.69% vs. 5%, p<0.001), shock (23.59% vs. 8.59%, p<0.001), ICU admission (25.54% vs. 12.28%, p<0.001) and AKI (47.71% vs. 28.52%, p<0.001). On multivariate analysis, patients with CDI had a statistically significant higher risk of mortality than those without (aOR-1.47, p<0.001). We also noted a statistically significant higher risk of sepsis (aOR-1.47, p<0.001), shock (aOR-2.7, p<0.001), AKI (aOR-1.55, p<0.001), and ICU admission (aOR-2.16, p<0.001) in the study population.
CONCLUSIONS: Our study revealed the prevalence of CDI in COVID-19 patients was 0.65%. Although the prevalence was low, its presence is associated with worse outcomes and higher resource utilization.
PMID:36662626 | DOI:10.1111/jgh.16128