Correlation Between Coinfection of Severe and Critically Ill COVID-19 Patients In Intensive Care Unit With Leucocyte, Neutrophil, CRP, Procalcitonin and Length of Stay

increases coinfection and lead to worsening prognosis. This study aims to determine the correlation between coinfection bacterial and fungal in COVID-19 with the value of the leukocyte, neutrophil, C-Reactive Protein (CRP), procalcitonin, length of stay and outcome whether it is discharge from ICU to ward or the patients passed away. Methods: This study is a retrospective cohort study. Data was obtained from medical record of patients admitted in ICU Saiful Anwar General Hospital Malang from August 2020 until August 2021, who were confirmed positive for COVID-19. There were 352 subjects that met the inclusion criteria. Results: Coinfection was found in 22,2% of our patients with bacterial (66/84,61%), fungal (9/11,53%) and both bacterial and fungal (3/3,84%). We found mean length of stay patients without coinfection was 6 days compared to 13 days with coinfection. We also found increased in mortality percentage of coinfection with 71.8% compared to 31% in non coinfection. Coinfection of bacterial, fungal, or both in COVID-19 have a positive correlation with Leucocyte (p = 0.001; r = 0.356), Neutrophil (p = 0.001 r = 0.438), CRP (p = 0.003; r = 0.164) and Procalcitonin (p = 0.001; r = 0.192) and positive correlation with length of stay (p = 0.001) and negative correlation with the outcome (p = 0.001). Conclusion: Coinfection was only found around one fifth of COVID-19 patients. We recommend antimicrobial prescription only if there was strong indication. Early identification of bacterial and fungal coinfection was necessary to identify high risk patients and determined appropriate interventions to prevent longer hospital stay and reduce mortality.