More than half of Covid patients with secondary infection die: ICMR | India News
The study showed that more than half of Covid-19 patients who contract a secondary infection from bacteria or fungi die. A secondary infection is one that occurs during or after treatment for another infection.
The numbers in the ICMR study are relatively small: 4% of the 17,000 Covid patients studied had secondary bacterial and fungal infections. But ICMR lead scientists Kamini Walia, who led the study, said extrapolating these numbers to total Covid-19 hospitalizations shows that thousands of people must have had a prolonged hospital stay, needing higher doses of antibiotics to prevent hospital acquired infections that typically develop after 10 days.
Covid-19 mortality worldwide is 10%. The subgroup of patients with Covid-19 plus a bacterial or fungal infection, which was part of the ICMR study, had 56.7% deaths.
The study also highlighted that many patients needed strong antibiotics, as they had superbugs that could not be treated with regular antibiotics. Half of the Covid patients with bacterial infection (52.36%) received antibiotics of “surveillance category” according to the World Health Organization; These are intended to be used wisely for specific types of infections. One fifth of these patients were administered antibiotics classified as “last resort” or reserve category.
The drug-resistant variants of pneumonia due to Klebsiella, acinetobacter baumannii, and pseudomonas aeruginosa are among the most common bacterial infections.
Many experts (unrelated to the study) believe that overuse of antibiotics and antifungals could have contributed to an increase in rare infections, such as black fungus or mucormycosis. “The body has an inherent flora, that is, good bacteria that play a protective role. But when antibiotics are given without a reason, these good bacteria are also killed, allowing opportunistic infections to attack, ”said intensivist Dr. Rahul Pandit, who is a member of the state government working group on Covid-19.
Dr Khusrav Bajan from Hinduja Hospital, Mahim said that studies conducted during the first wave of Covid-19 had shown that while 17% of Covid patients had secondary infections, 73% received antibiotics. “In the second wave, we are seeing young people who come to us after taking two or three antibiotics during the first phase of treatment at home. By the time they come to us, they need higher antibiotics, ”said Dr. Bajan, who is also a member of the task force.
In prolonged Covid patients who end up staying longer in hospitals, antibiotics are prescribed to prevent any hospital-acquired infections. “The longer a patient stays in the hospital, the greater the possibility that they will need an ICU or ventilator. Antibiotics are necessary for a Covid patient like this, but what is worrisome is the excess of antibiotics that could put ‘pressure’ on the pathogens that will end up becoming resistant to the drugs, ”said Dr. Walia.
The pattern of antibiotic use at home by Covid patients could also have long-term repercussions; After the rampant use of azithromycin, it remains to be seen whether it will be effective against typhoid fever in the future, Dr. Walia said.
Their study found that during the first wave, 10% of patients were given antifungals even though they didn’t need them. “Now, with the fear of mucormycosis, one is sure that many antifungals are being misused,” he added.
Dr. Sujata Baveja of Sion Hospital, who along with Hinduja Hospital contributed to the study, said the least hospitals can do is “cut back” treatment as soon as the patient’s condition improves.