{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T02:48:37Z","timestamp":1789181317974,"version":"build-2803163510"},"reference-count":47,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,7,2]],"date-time":"2023-07-02T00:00:00Z","timestamp":1688256000000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Patients with viral infections are at higher risk to acquire bacterial and fungal superinfections associated with a worse prognosis. We explored this critical point in the setting of patients with severe COVID\u201019 disease. The study included 1911 patients admitted to intensive care unit (ICU) during a 2\u2010year study period (March 2020\u2013March 2022). Of them, 713 (37.3%) were infected with SARS\u2010CoV\u20102 and 1198 were negative (62.7%). Regression analysis was performed to determine risk factors associated with the presence of bacterial and\/or fungal superinfections in SARS\u2010CoV\u20102 patients and to evaluate predictors of ICU mortality. Of the 713 patients with SARS\u2010CoV\u20102 infection, 473 (66.3%) had respiratory and\/or bloodstream bacterial and\/or fungal superinfections, while of the 1198 COVID\u201019\u2010negative patients, only 369 (30%) showed respiratory and\/or bloodstream bacterial and\/or fungal superinfections (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). Baseline characteristics of COVID\u201019 patients included a median age of 66 (interquartile range [IQR], 58\u201373), a predominance of males (72.7%), and the presence of a BMI higher than 24 (median 26; IQR, 24.5\u201330.4). Seventy\u2010four percent (527, 73.9%) had one or more comorbidities and 135 (18.9%) of them had received previous antibiotic therapy. Furthermore, most of them (473, 66.3%) exhibited severe radiological pictures and needed invasive mechanical ventilation. Multivariate logistic regression analysis showed that 1 unit increment in BMI rises the risk of bacterial and\/or fungal superinfections acquisition by 3% and 1\u2010day increment in ICU stays rises the risk of bacterial and\/or fungal superinfections acquisition by 11%. Furthermore, 1\u2010day increment in mechanical ventilation rises the risk of bacterial and\/or fungal superinfection acquisition by 2.7 times. Furthermore, patients with both bacterial and fungal infections had a significantly higher mortality rate than patients without superinfections (45.8% vs. 26.2%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). Therefore, bacterial and fungal superinfections are frequent in COVID\u201019 patients admitted to ICU and their presence is associated with a worse outcome. This is an important consideration for targeted therapies in critically ill SARS\u2010CoV\u20102 infected patients to improve their clinical course.<\/jats:p>","DOI":"10.1002\/jmv.28892","type":"journal-article","created":{"date-parts":[[2023,7,3]],"date-time":"2023-07-03T05:15:45Z","timestamp":1688361345000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Bacterial and fungal superinfections are detected at higher frequency in critically ill patients affected by SARS CoV\u20102 infection than negative patients and are associated to a worse outcome"],"prefix":"10.1002","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2221-6286","authenticated-orcid":false,"given":"Maria Antonia","family":"De Francesco","sequence":"first","affiliation":[{"name":"Institute of Microbiology, Department of Molecular and Translational Medicine, ASST Spedali Civili University of Brescia Brescia 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