The Burden of Clostridioides Difficile Infection during the COVID-19 Pandemic: A Retrospective Case-Control Study in Italian Hospitals (CloVid)

Granata, Guido; Bartoloni, Alessandro; Codeluppi, Mauro; Contadini, Ilaria; Cristini, Francesco; Fantoni, Massimo; Ferraresi, Alice; Fornabaio, Chiara; Grasselli, Sara; Lagi, Filippo; Masucci, Luca; Puoti, Massimo; Raimondi, Alessandro; Taddei, Eleonora; Trapani, Filippo; Viale, Pierluigi; Johnson, Stuart; Petrosillo, Nicola

doi:10.3390/jcm9123855

Cited by 61 publications

(78 citation statements)

References 25 publications

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“…Moreover, treatment of COVID-19 patients with broad-spectrum antibiotics has the potential to increase the risk of Clostridioides difficile ( C. difficile ) infection, including in survivors even long after recovery. In co-infections with SARS-CoV-2 and C. difficile , intestinal damage is more extensive and diarrhea symptoms are more severe[ 106 ]. To counteract the detrimental effects of various proinflammatory cytokines, biological therapy is used in selected patient groups.…”

Section: Virus-independent Causes Of Covid-19-associated Diarrheamentioning

confidence: 99%

COVID-19-associated diarrhea

Megyeri

Dernovics

Al-Luhaibi

et al. 2021

WJG

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) recently emerged as a highly virulent respiratory pathogen that is known as the causative agent of coronavirus disease 2019 (COVID-19). Diarrhea is a common early symptom in a significant proportion of patients with SARS-CoV-2 infection. SARS-CoV-2 can infect and replicate in esophageal cells and enterocytes, leading to direct damage to the intestinal epithelium. The infection decreases the level of angiotensin-converting enzyme 2 receptors, thereby altering the composition of the gut microbiota. SARS-CoV-2 elicits a cytokine storm, which contributes to gastrointestinal inflammation. The direct cytopathic effects of SARS-CoV-2, gut dysbiosis, and aberrant immune response result in increased intestinal permeability, which may exacerbate existing symptoms and worsen the prognosis. By exploring the elements of pathogenesis, several therapeutic options have emerged for the treatment of COVID-19 patients, such as biologics and biotherapeutic agents. However, the presence of SARS-CoV-2 in the feces may facilitate the spread of COVID-19 through fecal-oral transmission and contaminate the environment. Thus gastrointestinal SARS-CoV-2 infection has important epidemiological significance. The development of new therapeutic and preventive options is necessary to treat and restrict the spread of this severe and widespread infection more effectively. Therefore, we summarize the key elements involved in the pathogenesis and the epidemiology of COVID-19-associated diarrhea.

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Section: Virus-independent Causes Of Covid-19-associated Diarrheamentioning

confidence: 99%

COVID-19-associated diarrhea

Megyeri

Dernovics

Al-Luhaibi

et al. 2021

WJG

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“…Among them, one important aspect has been improved infection prevention measures such as higher compliance in hand hygiene and isolation precautions. 74,76 Only one small study specifically commented on CA-CDI versus HA-CDI, finding that six out of 38 CDI cases were community-onset, and two out of 38 were rCDI. 76 In that study, COVID-19 patients with CDI had worse outcome than those without CDI, including longer hospital stay (35 days versus 19.4 days, p < 0.01) and lower rates of full recovery without complications (50% versus 64.9%, p = 0.01).…”

Section: Covid-19 and CDImentioning

confidence: 99%

Epidemiology of community-acquired and recurrent Clostridioides difficile infection

Luo

Grinspan

2021

Therap Adv Gastroenterol

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Clostridioides difficile infection is a leading cause of healthcare-associated infections with significant morbidity and mortality. For the past decade, the bulk of infection prevention and epidemiologic surveillance efforts have been directed toward mitigating hospital-acquired C. difficile. However, the incidence of community-associated infection is on the rise. Patients with community-associated C. difficile tend to be younger and have lower mortality rate. Rates of recurrent C. difficile infection overall have decreased in the United States, but future research and public health endeavors are needed to standardize and improve disease detection, stratify risk factors in large-scale population studies, and to identify regional and local variations in strain types, reservoirs and transmission routes to help characterize and combat the changing epidemiology of C. difficile.

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“…The importance of appropriate case definitions for infection is underscored [91,93]. Unique co-infections with atypical or chronic bacterial infections (in addition to M. pneumoniae as previously discussed) have also been cited [94][95][96][97][98][99][100]. Among the latter, the finding of 20% of adults having concomitant Bordetella pertussis infections must raise again concern with the applicability of diagnostic methods [100].…”

Section: Co-detection Of Sars-cov-2 With Selected Non-viral Infections and Chronic Viral Infectionsmentioning

confidence: 99%

The Complexity of Co-Infections in the Era of COVID-19

Cimolai

2021

SN Compr. Clin. Med.

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The Burden of Clostridioides Difficile Infection during the COVID-19 Pandemic: A Retrospective Case-Control Study in Italian Hospitals (CloVid)

Cited by 61 publications

References 25 publications

COVID-19-associated diarrhea

COVID-19-associated diarrhea

Epidemiology of community-acquired and recurrent Clostridioides difficile infection

The Complexity of Co-Infections in the Era of COVID-19

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