P-1900. Temporal Course and Risk Factors of Coinfections in Patients Hospitalized for COVID-19

Abstract Background Studies about the distinction between coinfections acquired prior to admission and hospital-acquired coinfections and risk factors at different time point are limited. Methods We reviewed microbiology laboratory data of patients hospitalized for COVID-19 viral infection during January 1, 2024 to March 13, 2024. Results We collected data on 75 patients. The temporal course of coinfection rate was: 9.3% on the same day of hospital admission (Day 1); 10.7% on Day 2 to Day 4; 2.7% on Day 5 to Day 9; 14.7% after Day 9 . At any time point prior to or during the hospitalization or rehospitalization, 23 (30.7%) patients acquired infection of at least one organism. Univariate analysis showed younger age (69 years vs. 78 years, p=0.025), lower proportion of diabetic patients (17.4% vs. 44.2%, p=0.036), lower proportion of chronic kidney disease (17.4% vs. 40.4%, p=0.065), higher proportion of indwelling catheter (17.4% vs. 1.9%, p=0.029), higher proportion of cancer (34.8% vs.13.5%, p=0.057), similar prior antibiotics (43.5% vs. 36.5%, p=0.6), and significant higher proportion of prior corticosteroids (21.7% vs. 3.9%, p=0.025) in coinfected group than not-coinfected group. Multivariate analysis indicated that indwelling catheter at baseline (OR=45.8, 95%CI: 3.2-652.8, p=0.005) and prior corticosteroids (OR=17.1, 95%CI: 0.99-296.4, p=0.051) are the two independent risk factors for coinfection at admission. Younger age (OR=0.96, 95%CI: 0.918-1.000, p=0.0495) and prior corticosteroids (OR=52.6, 95%CI: 3.11-891.3, p=0.006) are the two independent risk factors for hospital-acquired coinfection. Conclusion About 10% of patients hospitalized for COVID-19 infection had coinfection(s) at admission, with Escherichia coli being the most common. The coinfections at admission were eradicated within eight days. The second wave of coinfection(s) acquired during hospitalization rose to about 15% after eight days, with Klebsiella being the most common. Patients with indwelling catheter or prior corticosteroids use are in much greater risk to be coinfected with COVID-19 before hospital admission. Patients with prior corticosteroids are at fifty-time higher risk for hospital-acquired coinfections. Disclosures All Authors: No reported disclosures