Panagiotis Mavroudis

Background: Bloodstream infections (BSI) caused by highly resistant pathogens in non-ICU COVID-19 departments pose important challenges. Methods: We performed a comparative analysis of incidence and microbial epidemiology of BSI in COVID-19 vs. non-COVID-19, non-ICU departments between 1 September 2020-31 October 2021. Risk factors for BSI and its impact on outcome were evaluated by a case-control study which included COVID-19 patients with/without BSI. Results: Forty out of 1985 COVID-19 patients developed BSI. The mean monthly incidence/100 admissions was 2.015 in COVID-19 and 1.742 in non-COVID-19 departments. Enterococcus and Candida isolates predominated in the COVID-19 group (p < 0.001 and p = 0.018, respectively). All Acinetobacter baumannii isolates were carbapenem-resistant (CR). In the COVID-19 group, 33.3% of Klebsiella pneumoniae was CR, 50% of Escherichia coli produced ESBL and 19% of Enterococcus spp. were VRE vs. 74.5%, 26.1% and 8.8% in the non-COVID-19 group, respectively. BSI was associated with prior hospitalization (p = 0.003), >2 comorbidities (p < 0.001), central venous catheter (p = 0.015), severe SARS-CoV-2 pneumonia and lack of COVID-19 vaccination (p < 0.001). In the multivariate regression model also including age and multiple comorbidities, only BSI was significantly associated with adverse in-hospital outcome [OR (CI95%): 21.47 (3.86−119.21), p < 0.001]. Conclusions: BSI complicates unvaccinated patients with severe SARS-CoV-2 pneumonia and increases mortality. BSI pathogens and resistance profiles differ among COVID-19/non-COVID-19 departments, suggesting various routes of pathogen acquisition.

The purpose of the present note is to prove the existence of common hypercyclic entire functions for the family of differential operators $\{ \lambda p(D) :\lambda \in \mathbb{C} \setminus \{ 0\} \}$, where $D$ is the differentiation operator acting on th

In Greek hospitals, all deaths with a positive SARS-CoV-2 test are counted as COVID-19 deaths. Our aim was to investigate whether COVID-19 was the primary cause of death, a contributing cause of death or not-related to death amongst patients who died in hospitals during the Omicron surge and were registered as COVID-19 deaths. Additionally, we aimed to analyze the factors associated with the classification of these deaths. We retrospectively re-viewed all in-hospital deaths, that were reported as COVID-19 deaths, in 7 hospitals, serving Athens, Greece, from January 1, 2022, until August 31, 2022. We retrieved clinical and laboratory data from patient records. Each death reported as COVID-19 death was characterized as: (A) death "due to" COVID-19, or (B) death "with" COVID-19. We reviewed 530 in-hospital deaths, classified as COVID-19 deaths (52.4% males; mean age 81.7 ± 11.1 years). We categorized 290 (54.7%) deaths as attributable or related to COVID-19 and in 240 (45.3%) deaths unrelated to COVID-19 In multivariable analysis The two groups differed significantly in age (83.6 ± 9.8 vs. 79.9 ± 11.8, p = 0.016), immunosuppression history (11% vs. 18.8%, p = 0.027), history of liver disease (1.4% vs. 8.4%, p = 0.047) and the presence of COVID-19 symptoms (p < 0.001). Hospital stay was greater in persons dying from non-COVID-19 related causes. Among 530 in-hospital deaths, registered as COVID-19 deaths, in seven hospitals in Athens during the Omicron wave, 240 (45.28%) were reassessed as not directly attributable to COVID-19. Accuracy in defining the cause of death during the COVID-19 pandemic is of paramount importance for surveillance and intervention purposes.

Background Omicron-1 COVID-19 is less invasive in the general population than previous viral variants. However, clinical course and outcome of hospitalised patients with SARS-CoV-2 pneumonia during the shift of the predominance from Delta to Omicron variants are not fully explored.Methods During January 2022 consecutively hospitalised patients with SARS-CoV-2 pneumonia were analysed. SARS-CoV-2 variants were identified by a 2-step pre-screening protocol and randomly confirmed by whole genome sequencing analysis. Clinical, laboratory and treatment data split by type of variant were analysed along with logistic regression of factors associated to mortality.Results 150 patients [mean age (SD) 67.2(15.8) years, male 54%] were analysed. Compared to Delta (n = 46), Omicron-1 patients (n = 104) were older [mean age (SD): 69.5(15.4) vs 61.9(15.8) years, p = 0.007], with more comorbidities (89.4% vs 65.2%, p = 0.001), less obesity (BMI >30Kg/m2 in 24% vs 43.5%, p = 0.034) but higher vaccination rates for COVID-19 (52.9% vs 8.7%, p < 0.001). Severe pneumonia (48.7%), pulmonary embolism (4.7%), need for invasive mechanical ventilation (8%), administration of dexamethasone (76%) and 60-day mortality (22.6%) did not significantly differ. Severe SARS-CoV-2 pneumonia independently predicted mortality [OR 8.297 (CI95% 2.080–33.095), p = 0.003]. Remdesivir administration (n = 135) was protective from death both in unadjusted and adjusted models [OR 0.157 (CI95% 0.026-0.945), p = 0.043.Conclusions In a COVID-19 department the severity of pneumonia that did not differ between Omicron-1 and Delta variants predicted mortality whilst remdesivir remained protective in all analyses. Death rates did not differ between SARS-CoV-2 variants. Vigilance and consistency with prevention and treatment guidelines for COVID-19 is mandatory regardless of the predominant SARS-CoV-2 variant

Intraparenchymal lung abscess development associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is a rare complication, with only half a dozen primary cases having been reported in the literature. We present the case of a patient with Waldenström's macroglobulinemia who developed a lung abscess subsequent to a primary SARS-CoV-2 infection. We present a 63-year-old male patient with SARS-CoV-2 infection and a history of Waldenström's macroglobulinemia who developed a cavitating intraparenchymal lung abscess with an air-fluid level in his right lower lobe two weeks following admission to hospital. The patient became septic and developed acute respiratory failure requiring mechanical ventilation and intensive care. He was managed with broad-spectrum antibiotic therapy and aspiration drainage, but unfortunately due to his severe clinical condition died 20 days after his initial admission. The development of a lung abscess in patients with COVID-19, although rare, can be quite compromising and even prove fatal, especially in immunocompromised patients. Clinicians should be aware of this potential complication.