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Background: Coronavirus disease 2019 (COVID-19) has now spread to most countries and regions of the world. Risk factors associated with multi-drug resistant organism (MDRO) infections in patients with COVID-19 have not been well studied yet. In the present study, we aimed to identify the risk factors associated with the MDRO infections and their impact on in-hospital mortality of COVID-19 patients. Methods: This retrospective cohort study was conducted between December 2019 and April 2020 at two tertiary hospitals in Wuhan, China. Data of cases were collected through electronic medical records system. This study was focused on cases with bacterial culture records. Risk factors and outcomes associated with MDRO infections were analyzed using logistic regression model. Results: Of the 2891 patients, 370 patients have bacterial culture results, and MDROs were isolated in 38 patients. Respiratory tract infections (67.3%) were the most common hospital acquired infections. Variables independently associated with MDRO infections were dyspnea at admission (odds ratio (OR) 4.74; 95% confidence interval (CI) 2.06-10.88; P < 0.001), intensive care unit (ICU) admission (OR 5.02; 95% CI 1.99-12.63; P < 0.01), and invasive mechanical ventilation (OR 5.13; 95% CI 2.15-12.27; P < 0.001), adjusted for age and gender. MDROs infection was also a significant risk factor of death for the patients, adjusted for age, gender, severity of illness, ICU admission and mechanical ventilation (OR 1.12, 95% CI: 0.43-2.96, P = 0.817). Conclusion: In our study, dyspnea at admission, ICU admission and invasive mechanical ventilation were associated with the presence of MDRO infections, and clinicians should be alert in MDRO infections in COVID-19 hospitalized patients. [ABSTRACT FROM AUTHOR]

Ambroxol is a commonly used mucolytic agent principally used to treat respiratory diseases, which may have a role as adjunctive therapy for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, but there is lack of evidence about its effectiveness on coronavirus disease-2019 (COVID-19) patients. To study the association between ambroxol use and clinical outcomes among hospitalized patients of COVID-19 infection. We conducted a multicenter retrospective cohort study involving 3,111 patients with confirmed SARS-CoV-2 infection from three hospitals in Wuhan from 19 December 2019 to 15 April 2020, and the primary outcome was in-hospital mortality. COVID-19 patients were classified into ambroxol and non-ambroxol groups based on the administration of ambroxol during hospitalization. Two analyses including propensity score matching (PSM) to obtain a 1:1 balanced cohort and logistic regression were used to control for confounding factors. The average age of 3,111 patients was 57.55 ± 14.93 years old, 127 of them died during hospitalization, and 924 of them used ambroxol. Treatment with ambroxol did not have a significant effect on in-hospital mortality of COVID-19 patients when compared with non-ambroxol in PSM model after adjusting for confounders (8.0% vs. 3.5%, adjusted OR, 1.03 [95% CI, 0.54–1.97], p = 0.936). Adverse events such as nausea/vomiting, headache, and rash were comparable between the two groups. Our results suggest that the use of ambroxol is not significantly associated with in-hospital mortality in COVID-19 patients, which provides evidence for evaluating the effects of ambroxol on COVID-19 patient outcomes and may be helpful for physicians considering medication alternatives for COVID-19 patients. [ABSTRACT FROM AUTHOR]