The Recent Increase in Invasive Bacterial Infections A Report From the National COVID Cohort Collaborative

Background: When coronavirus disease 2019 (COVID-19) mitigation efforts waned, viral respiratory infections (VRIs) surged, potentially increasing the risk of postviral invasive bacterial infections (IBIs). We sought to evaluate the change in epidemiology and relationships between specific VRIs and IBIs [complicated pneumonia, complicated sinusitis and invasive group A streptococcus (iGAS)] over time using the National COVID Cohort Collaborative (N3C) dataset. Methods: We performed a secondary analysis of all prospectively collected pediatric (<19 years old) and adult encounters at 58 N3C institutions, stratified by era: pre-pandemic (January 1, 2018, to February 28, 2020) versus pandemic (March 1, 2020, to June 1, 2023). We compared the characteristics and outcomes of patients with prespecified VRIs and IBIs, including correlation between VRI cases and subsequent IBI cases. Results: We identified 965,777 pediatric and 9,336,737 adult hospitalizations. Compared with pre-pandemic, pandemic-era children demonstrated higher mean monthly cases of adenovirus (121 vs. 79.1), iGAS (5.8 vs. 3.3), complicated pneumonia (282 vs. 178) and complicated sinusitis (29.8 vs. 16.3), P < 0.005 for all. Among pandemic-era children, peak correlation between RSV cases and subsequent complicated sinusitis cases occurred with a 60-day lag (correlation coefficient 0.56, 95% confidence interval: 0.52–0.59, P < 0.001) while peak correlation between influenza and complicated sinusitis occurred with a 33-day lag (0.55, 0.51–0.58, P < 0.001). Correlation among other VRI–IBI pairs was modest during the pandemic and often lower than during the pre-pandemic era. Conclusions: Since COVID-19 emerged, mean monthly cases of iGAS, complicatedpneumonia,andcomplicatedsinusitishavebeenhigher.Pandemic-era RSV and influenza cases were correlated with subsequent cases of complicated sinusitis in children. However, many other VRI–IBI correlations decreased during the pandemic.

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UNC Libraries
Published
2025-03-08
DOI
https://doi.org/10.17615/dc12-5568
Primary Topic
Pneumonia and Respiratory Infections
Type
article
Field-Weighted Citation Impact
0.00

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article

The Recent Increase in Invasive Bacterial Infections A Report From the National COVID Cohort Collaborative

Seth Russell, Boris Martin, Jain Abhishek R, L. Nelson Sanchez‐Pinto et al.
UNC Libraries
Pneumonia and Respiratory Infections
article

The Recent Increase in Invasive Bacterial Infections A Report From the National COVID Cohort Collaborative

Seth Russell, Boris Martin, Jain Abhishek R, L. Nelson Sanchez‐Pinto, Melissa Haendel, Robert Moffitt, Bennett T.D., N C Consortium, Dorinda Shelley E., Aarav Kannan J
article en

Abstract

Background: When coronavirus disease 2019 (COVID-19) mitigation efforts waned, viral respiratory infections (VRIs) surged, potentially increasing the risk of postviral invasive bacterial infections (IBIs). We sought to evaluate the change in epidemiology and relationships between specific VRIs and IBIs [complicated pneumonia, complicated sinusitis and invasive group A streptococcus (iGAS)] over time using the National COVID Cohort Collaborative (N3C) dataset. Methods: We performed a secondary analysis of all prospectively collected pediatric (<19 years old) and adult encounters at 58 N3C institutions, stratified by era: pre-pandemic (January 1, 2018, to February 28, 2020) versus pandemic (March 1, 2020, to June 1, 2023). We compared the characteristics and outcomes of patients with prespecified VRIs and IBIs, including correlation between VRI cases and subsequent IBI cases. Results: We identified 965,777 pediatric and 9,336,737 adult hospitalizations. Compared with pre-pandemic, pandemic-era children demonstrated higher mean monthly cases of adenovirus (121 vs. 79.1), iGAS (5.8 vs. 3.3), complicated pneumonia (282 vs. 178) and complicated sinusitis (29.8 vs. 16.3), P < 0.005 for all. Among pandemic-era children, peak correlation between RSV cases and subsequent complicated sinusitis cases occurred with a 60-day lag (correlation coefficient 0.56, 95% confidence interval: 0.52–0.59, P < 0.001) while peak correlation between influenza and complicated sinusitis occurred with a 33-day lag (0.55, 0.51–0.58, P < 0.001). Correlation among other VRI–IBI pairs was modest during the pandemic and often lower than during the pre-pandemic era. Conclusions: Since COVID-19 emerged, mean monthly cases of iGAS, complicatedpneumonia,andcomplicatedsinusitishavebeenhigher.Pandemic-era RSV and influenza cases were correlated with subsequent cases of complicated sinusitis in children. However, many other VRI–IBI correlations decreased during the pandemic.

UNC Libraries
University of North Carolina at Chapel Hill (US)
Bill and Melinda Gates Foundation, Yale University, Brown University, Vanderbilt University, University of Miami, University of Pennsylvania, NYU Langone Medical Center, Northwestern University, Wake Forest University, Children's Hospital Colorado, Vanderbilt Institute for Clinical and Translational Research, Johns Hopkins University, Institute for Translational Medicine and Therapeutics, Institute of Clinical and Translational Sciences, Case Western Reserve University, Pennsylvania State University, Carilion Clinic, University of South Carolina, Aurora Health Care, Virginia Commonwealth University, Southern California Clinical and Translational Science Institute, MedStar Health Research Institute, Georgetown-Howard Universities Center for Clinical and Translational Science, NorthShore University HealthSystem, Penn State Clinical and Translational Science Institute, Louisiana Clinical and Translational Science Center, Ochsner Health, West Virginia Clinical and Translational Science Institute, Stony Brook University, National Institutes of Health, Institute for Clinical and Translational Research, University of Wisconsin, Madison, Weill Cornell Medical College, Oregon Clinical and Translational Research Institute, University of California, Irvine, Leonard M. Miller School of Medicine, Center for Clinical and Translational Research, Center for Clinical and Translational Science, Mayo Clinic, Center for Clinical and Translational Sciences, University of Texas Health Science Center at Houston, Irving Medical Center, Columbia University, Translational Research Institute, University of Arkansas for Medical Sciences, South Carolina Clinical and Translational Research Institute, Medical University of South Carolina, Clinical and Translational Science Institute, University of Florida, Clinical and Translational Science Institute, Boston University, Clinical and Translational Science Center, University of New Mexico, National Center for Advancing Translational Sciences, Institute for Integration of Medicine and Science, Colorado Clinical and Translational Sciences Institute, Yale Center for Clinical Investigation, Yale School of Medicine, Institute for Clinical and Translational Science, University of California, Irvine, Wake Forest Clinical and Translational Science Institute, Wake Forest School of Medicine, Accelerated Innovation Research Initiative Turning Top Science and Ideas into High-Impact Values
Openalex Percentile: Top 55%
Pneumonia and Respiratory Infections
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