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Llor C, Ouchi D, Giner-Soriano M, et al. Correlation between Previous Antibiotic Exposure and COVID-19 Severity. A Population-Based Cohort Study. Antibiotics (Basel). 2021;10(11)doi: 10.3390/antibiotics10111364.
Llor, C., Ouchi, D., Giner-Soriano, M., García-Sangenís, A., Bjerrum, L., & Morros, R. (2021). Correlation between Previous Antibiotic Exposure and COVID-19 Severity. A Population-Based Cohort Study. Antibiotics (Basel, Switzerland), 10(11), . https://doi.org/10.3390/antibiotics10111364
Llor, Carl, et al. "Correlation between Previous Antibiotic Exposure and COVID-19 Severity. A Population-Based Cohort Study." Antibiotics (Basel, Switzerland) vol. 10,11 (2021). doi: https://doi.org/10.3390/antibiotics10111364
Llor C, Ouchi D, Giner-Soriano M, García-Sangenís A, Bjerrum L, Morros R. Correlation between Previous Antibiotic Exposure and COVID-19 Severity. A Population-Based Cohort Study. Antibiotics (Basel). 2021 Nov 08;10(11). doi: 10.3390/antibiotics10111364. PMID: 34827302; PMCID: PMC8615228.
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Antibiotics (Basel). 2021 Nov 08;10(11). doi: 10.3390/antibiotics10111364.

Correlation between Previous Antibiotic Exposure and COVID-19 Severity. A Population-Based Cohort Study.

Antibiotics (Basel, Switzerland)

Carl Llor, Dan Ouchi, Maria Giner-Soriano, Ana García-Sangenís, Lars Bjerrum, Rosa Morros

Affiliations

  1. Fundació Institut Universitari per la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain.
  2. Department of Public Health, General Practice, University of Southern Denmark, 5000 Odense, Denmark.
  3. Universitat Autònoma de Barcelona, Bellaterra, 08193 Cerdanyola del Vallès, Spain.
  4. Section and Research Unit of General Practice, Department of Public Health, University of Copenhagen, 1014 Copenhagen, Denmark.
  5. Departament de Farmacologia, Terapèutica i Toxicologia, Universitat Autònoma de Barcelona, Bellaterra, 08193 Cerdanyola del Vallès, Spain.
  6. Plataforma SCReN, IICEC IDIAP Jordi Gol, 08007 Barcelona, Spain.

PMID: 34827302 PMCID: PMC8615228 DOI: 10.3390/antibiotics10111364

Abstract

We examined the correlation between previous antibiotic exposure and COVID-19 severity using a population-based observational matched cohort study with patient level data obtained for more than 5.8 million people registered in SIDIAP in Catalonia, Spain. We included all patients newly diagnosed with COVID-19 from March to June 2020 and identified all their antibiotic prescriptions in the previous two years. We used a composite severity endpoint, including pneumonia, hospital admission and death due to COVID-19. We examined the influence of high antibiotic exposure (>4 regimens), exposure to highest priority critically important antimicrobials (HPCIA) and recent exposure. Potential confounders were adjusted by logistic regression. A total of 280,679 patients were diagnosed with COVID-19, 146,656 of whom were exposed to at least one antibiotic course (52.3%) during the preceding two years. A total of 25,222 presented severe COVID-19 infection (9%), and the risk of severity was highest among those exposed to antibiotics (OR 1.12; 95% CI: 1.04-1.21). Among all individuals exposed to antibiotics, high, recent and exposure to HPCIAs were correlated with increased COVID severity (OR 1.19; 95% CI: 1.14-1.26; 1.41; 95% CI: 1.36-1.46; and 1.35; 95% CI: 1.30-1.40, respectively). Our findings confirm a significant correlation between previous antibiotic exposure and increased severity of COVID-19 disease.

Keywords: COVID-19; anti-bacterial agents; drug resistance; microbial; primary health care

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