Background Previous viral pandemics have shown that secondary bacterial infections result in higher morbidity and mortality, with Staphylococcus aureus as the primary causative pathogen. The impact of secondary S. aureus bacteremia on mortality in patients infected with SARS-CoV-2 remains unknown. Methods This was a retrospective, observational case series of patients with COVID-19 disease who developed secondary S. aureus bacteremia across two New York City hospitals. The primary endpoint was to describe 14-day and 30-day hospital mortality rates of patients infected with COVID-19 and S. aureus bacteremia. Secondary endpoints included predictors of 14-day and 30-day hospital mortality in patients infected with COVID-19 and S. aureus bacteremia. Results A total of 42 hospitalized patients for COVID-19 with secondary S. aureus bacteremia were identified. Of these patients, 23 (54.8 %) and 28 (66.7%) died at 14 days and 30 days, respectively, from their first positive blood culture. Multivariate analysis identified hospital-onset bacteremia (≥4 days from date of admission) and age as significant predictors of 14-day hospital mortality, and Pitt bacteremia score as a significant predictor of 30-day hospital mortality (odds ratio [OR] 11.9 [95% confidence interval [CI] 2.03-114.7], p=0.01; (OR 1.10 [95% CI 1.03-1.20], p=0.02); and (OR 1.56 [95% CI 1.19-2.18], p=0.003), respectively. Conclusions Bacteremia with S. aureus is associated with high mortality rates in patients hospitalized with COVID-19 infection. Further investigation is warranted to understand the impact of COVID-19 and secondary S. aureus bacteremia.

Severe Acute Respiratory Syndrome Coronavirus—2 (SARS CoV-2) has resulted in the global spread of Coronavirus Disease 2019 (COVID-19) and an increase in complications including Acute Respiratory Distress Syndrome (ARDS). Due to the lack of therapeutic options for Acute Respiratory Distress Syndrome, recent attention has focused on differentiating hyper- and hypo-inflammatory phenotypes of ARDS to help define effective therapeutic strategies. Interleukin 8 (IL-8) is a pro-inflammatory cytokine that has a role in neutrophil activation and has been identified within the pathogenesis and progression of this disease. The aim of this review is to highlight the role of IL-8 as a biomarker and prognostic factor in modulating the hyperinflammatory response in ARDS. The crucial role of IL-8 in lung inflammation and disease pathogenesis might suggest IL-8 as a possible new therapeutic target to efficiently modulate the hyperinflammatory response in ARDS.

Thromboembolism and myocardial injury is common in patients with COVID-19. Low-molecular-weight heparin appears to be associated with a good prognosis in patients with COVID-19 and has the ability to reduce coagulation and inflammation markers. Hospitalized patients with COVID-19 should be placed on thromboprophylaxis with the option of full therapeutic anticoagulation or tissue plasminogen activator in high-risk or mechanically ventilated patients. Thromboprophylaxis should also be considered at hospital discharge for high-risk patients. Clinical judgment should be used to evaluate the bleeding and safety risk of anticoagulation in patients with COVID-19 without confirmed data.

The use of a double histamine blockade is an inexpensive, safe, and effective way to alleviate bone pain symptoms secondary to G-CSF agents. Further investigation is warranted for prospective larger studies to confirm these results.