scholarly journals Evidence for the utility of cfDNA plasma concentrations to predict disease severity in COVID-19

2021 ◽  
Author(s):  
Katharina Hoeter ◽  
Elmo Neuberger ◽  
Susanne Fischer ◽  
Manuel Herbst ◽  
Ema Juškevičiūtė ◽  
...  
Keyword(s):  
Disease Severity ◽  
Clinical Laboratory ◽  
Medical Center ◽  
Plasma Concentrations ◽  
Kidney Injury ◽  
Predictive Biomarker ◽  
Neurological Complications ◽  
Reactive Protein ◽  
Heparin Plasma ◽  
The University

AbstractCOVID-19 is a pandemic caused by the highly infective SARS-CoV-2. There is a need for biomarkers not only for overall prognosis but also for predicting the response to treatments and thus for improvements in the clinical management of patients with COVID-19. Circulating cell-free DNA (cfDNA) has emerged as a promising biomarker in the assessment of various disease conditions. The aim of this retrospective and observational pilot study was to examine the potential value of cfDNA plasma concentrations as a correlative biomarker in hospitalized COVID-19 patients. Lithium-Heparin plasma samples were obtained from twenty-one COVID-19 patients during hospitalization in the University Medical Center of Mainz, Germany, and the cfDNA concentrations were determined by quantitative PCR yielding amplicons of long interspersed nuclear elements (LINE-1). cfDNA plasma concentrations of COVID-19 patients ranged between 247.5 and 6346.25 ng/ml and the mean concentrations were 1831 ± 1388 ng/ml (± standard deviation). Correlations were found between cfDNA levels and the occurrence of acute respiratory distress symptom (ARDS), acute kidney injury (AKI), myositis, neurological complications, bacterial superinfection and disease severity as defined by sepsis-related organ failure assessment score (SOFA) score. D-Dimer and C-reactive-protein (CRP), determined by clinical laboratory analysis, showed the highest correlations with cfDNA levels. The results of this observational study suggest that cfDNA plasma concentrations may serve as a predictive biomarker of disease severity in COVID-19. Prospective studies enrolling larger patient cohorts are ongoing to test this hypothesis.

scholarly journals Polyphenol-rich extract of Ocimum gratissimum leaves prevented toxic effects of cyclophosphamide on the kidney function of Wistar rats

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Quadri K. Alabi ◽  
Rufus O. Akomolafe ◽  
Joseph G. Omole ◽  
Ayodeji Aturamu ◽  
Mokolade S. Ige ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Renal Function ◽  
Low Cost ◽  
Plasma Concentrations ◽  
Kidney Injury ◽  
Albumin Concentration ◽  
Ocimum Gratissimum ◽  
Reactive Protein ◽  
Urine Albumin ◽  
Aldosterone Production

Abstract Background Cyclophosphamide (CP) is one of the potent and low cost chemotherapy used in clinical setting against a variety of tumors. However, its association with nephrotoxicity limits its therapeutic use. Ocimum gratissimum leaf is a medicinal plant with numerous pharmacological and therapeutic efficacies, such as antioxidant, anti-inflammation, and anti-apoptotic properties. Methods The present study was designed to evaluate the protective effect of Ocimum gratissimum (OG) against CP-induced kidney dysfunction in rats. Rats were pre-treated with 400 mg/kg b.w. of leave extract of Ocimum gratissimum (Ocimum G.) for 4 days and then 50 mg/kg b.w. of CP was co-administered from day 5 to day 7 along with Ocimum G. Markers of renal function and oxidative stress, food and water intake, electrolytes, aldosterone, leukocytes infiltration, inflammation and histopathological alteration were evaluated. Results Obvious renal inflammation and kidney injuries were observed in CP treated groups. However, administration of leave extract of Ocimum G. prevented oxidative stress, kidney injuries, attenuated inflammation, increased aldosterone production and reduced sodium ion and water loss in rats. The plasma creatinine, urea and urine albumin concentration were normalized after the administration of Ocimum G. extract in rats treated with CP. Ocimum G. also decreased the plasma concentrations of Interleukin-(IL)-6, C-reactive protein and activity of myeloperoxidase and malondialdehyde in CP treated rats. Conclusion Ocimum G. prevented kidney injury and enhanced renal function via inhibiting inflammation and oxidant-induced CP toxicity. The efficacy of Ocimum G. is related to the presence of various phytochemicals in the plant.

scholarly journals Molecular Epidemiology and Clinical Features Analysis of Respiratory Adenovirus Infections Reveals Correlations between Genotype, Inflammatory Biomarkers, and Disease Severity

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Hui Dai ◽  
Hongli Xi ◽  
Li Huang ◽  
Zhaohu Yuan ◽  
Yike Liao ◽  
...  
Keyword(s):  
Disease Severity ◽  
Clinical Laboratory ◽  
Respiratory Infections ◽  
Cross Sectional Study ◽  
Inflammatory Biomarkers ◽  
Hospitalized Children ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Clinical Profiles

Background. Human adenoviruses (HAdVs) are commonly causing respiratory disease. We molecularly genotyped HAdV circulating in Chinese hospitalized children with respiratory infections and summarized the clinical profiles and common inflammatory biomarkers, so as to better determine their associations with disease severity. Method. Children with respiratory single HAdV infection cases that occurred from December 2017 to March 2019 were enrolled for a cross-sectional study. Clinical/laboratory features based on the genotypes of respiratory HAdV infection were reviewed for comparative analysis. Results. A total of 84 patients were enrolled, and HAdV types were identified from 82 patients. Species B (HAdV-7, 44%; HAdV-3, 43%, and HAdV-14, 5%) was the most common, followed by C (HAdV-2, 4% and HAdV-1, 1%) and E (HAdV-4, 1%). Severe HAdV infection and HAdV-7 infection groups were associated with significantly longer duration of fever and hospitalized days, higher morbidity of tachypnea/dyspnea, more pleural effusion, more respiratory rales, more frequently required mechanical ventilation, and significantly higher fatality rate. The elevated procalcitonin (PCT) and C-reactive protein (CRP) levels were significantly associated with severe HAdV infection. Conclusions. HAdV-7 and HAdV-3 were the most common types among children with respiratory adenovirus infection; vaccines against these two genotypes are in urgent need. PCT and CRP are significantly associated with the severity of HAdV infection.

scholarly journals Elevated Plasma Fibrinogen Is Associated With Excessive Inflammation and Disease Severity in COVID-19 Patients

2021 ◽  
Vol 11 ◽  
Author(s):  
Jingrui Sui ◽  
Denis F. Noubouossie ◽  
Sheetal Gandotra ◽  
Liyun Cao
Keyword(s):  
Disease Severity ◽  
Troponin I ◽  
Medical Center ◽  
Severe Disease ◽  
Cardiac Injury ◽  
High Sensitivity ◽  
University Of Alabama ◽  
Optimal Cutoff ◽  
Icu Admission ◽  
The University

BackgroundThe coronavirus disease-19 (COVID-19) is characterized with intense inflammatory response, cardiac involvement, and coagulopathy. Fibrinogen, as a biomarker for inflammation, cardiovascular disease, and coagulation, has not been fully investigated yet. The aim of this study was to assess the clinical application of fibrinogen in COVID-19 patients.MethodsWe retrospectively analyzed the demographic and laboratory characteristics of 119 COVID-19 patients in the University of Alabama of Birmingham Medical Center. Correlations of fibrinogen on admission with intensive care unit (ICU) admission, disease severity, and laboratory parameters were analyzed.ResultsAmong the 119 COVID-19 patients, 77.3% (92/119) had severe disease, and 59.5% (71/119) patients were admitted to the ICU. Elevated fibrinogen was detected in 67.2% (80/119) of the patients. Fibrinogen levels were significantly associated with inflammatory markers and disease severity, but not with cardiac injury biomarker high sensitivity troponin I. Patients with severe disease had increased fibrinogen levels upon admission compared to patients with non-severe disease (P = 0.001). Fibrinogen level at 528.0 mg/dl was the optimal cutoff to predict disease severity, with a sensitivity and specificity of 66.7% and 70.3% (area undty -60er the curve [AUC] 0.72, P = 0.0006).ConclusionsFibrinogen is commonly elevated in COVID-19 patients, especially in those with severe disease. Elevated fibrinogen correlates with excessive inflammation, disease severity, and ICU admission in COVID-19 patients.

scholarly journals Polyphenol-rich extract of Ocimum gratissimum leaves Prevented Toxic Effects of Cyclophosphamide on the kidney Function of Wistar rats

2021 ◽  
Author(s):  
Quadri K. Alabi ◽  
Rufus O. Akomolafe ◽  
Joseph G. Akomolafe ◽  
Ayodeji Aturamu ◽  
Mokolade S. Ige ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Renal Function ◽  
Low Cost ◽  
Plasma Concentrations ◽  
Kidney Injury ◽  
Ocimum Gratissimum ◽  
Reactive Protein ◽  
Aldosterone Production ◽  
Food And Water Intake ◽  
And Oxidative Stress

Abstract Background Cyclophosphamide (CP) is one of the potent and low cost chemotherapy used in clinical setting against a variety of tumors. However, its association with nephrotoxicity limits its therapeutic use. Ocimum gratissimum leaf is a natural plant with numerous pharmacological and therapeutic efficacies, such as antioxidant, anti-inflammation, and anti-apoptotic properties.Methods The present study was designed to evaluate the protective effect of Ocimum gratissimum (OG) against CP-induced kidney dysfunction in rats. Rats were pre-treated with 400 mg/kg b.w. of polyphenol-rich Ocimum gratissimum leaves (PREOG) for 4 days and then 50 mg/kg b.w. of CP was co-administered from day 5 to day 7 along with PREOG. Markers of renal function and oxidative stress, food and water intake, electrolytes, aldosterone, leukocytes infiltration, inflammation and histopathological alteration were evaluated.Results Obvious renal inflammation and kidney injuries were observed in CP treated groups. PREOG administration prevented oxidative stress, kidney injuries, attenuated inflammation, increased aldosterone production and reduced sodium and water loss in rats. PREOG also decreased the plasma concentrations of Interleukin-(IL)-6, C-reactive protein and activity of myeloperoxidase and malondialdehyde in CP treated rats.Conclusion OG prevented kidney injury and enhanced renal function via inhibiting inflammation and oxidant-induced CP toxicity. The efficacy of OG is related to the presence of various phytochemicals in the plant.

scholarly journals Clinical features and disease severity in an Iranian population of COVID-19 patients

2020 ◽  
Author(s):  
Shima Nabavi ◽  
Zahra Javidarabshahi ◽  
Abolghasem Allahyari ◽  
Mohammad Ramezani ◽  
Mohsen Seddigh-Shamsi ◽  
...  
Keyword(s):  
Disease Severity ◽  
Clinical Features ◽  
Clinical Laboratory ◽  
Severe Disease ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Radiologic Findings ◽  
Severity Of The Disease ◽  
Lung Ct

Abstract Objectives: Coronavirus disease 2019 (COVID-19) can present with a variety of symptoms. Severity of the disease may be associated with several factors. Here, we review clinical features of COVID-19 patients with different severities.Methods: This cross-sectional study was performed in Imam Reza hospital, Mashhad, Iran, during February-April 2020. COVID-19 patients with typical computed tomography (CT) patterns and/or positive reverse-transcriptase polymerase chain reaction (RT-PCR) were included. The patients were classified into three groups of moderate, severe, and critical based on disease severity. Demographic, clinical, laboratory, and radiologic findings were collected and compared. P<0.05 was considered statistically significant.Results: Overall, 200 patients with mean age of 69.75±6.39 years, of whom 82 (41%) were female were studied. Disease was severe/critical in the majority of patients (167, 83.5%). Disease severity was significantly associated with age, malignant comorbidities, dyspnea, nausea/vomiting, confusion, respiratory rate, pulse rate, O2 saturation, extent of CT involvement, serum C-reactive protein (CRP), pH, pO2, and aspartate transaminase (P<0.05). Moreover, complications including shock, coagulopathy, acidosis, sepsis, acute respiratory distress syndrome (ARDS), intensive care unit (ICU) admission, and intubation were significantly higher in patients with higher severities. O2 saturation, nausea/vomiting, and extent of lung CT involvement were independent predictors of severe/critical COVID-19 (OR=0.342, 45.93, and 25.48, respectively; P<0.05).Conclusions: Our results indicate O2 saturation, nausea/vomiting, and extent of lung CT involvement as independent predictors of severe COVID-19 conditions. Serum CRP levels and pO2 were also considerably higher patients with higher severity and can be used along with other factors as possible predictors of severe disease in COVID-19 patients.

scholarly journals Acute Kidney Injury Associated with Coronavirus Disease 2019 in Urban New Orleans

Kidney360 ◽  
2020 ◽  
Vol 1 (7) ◽  
pp. 614-622 ◽  
Author(s):  
Muner M.B. Mohamed ◽  
Ivo Lukitsch ◽  
Aldo E. Torres-Ortiz ◽  
Joseph B. Walker ◽  
Vipin Varghese ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
New Orleans ◽  
Medical Center ◽  
Inflammatory Marker ◽  
Kidney Injury ◽  
Black Population ◽  
Hemodynamic Instability ◽  
The United States ◽  
Predominantly Black ◽  
Reactive Protein

BackgroundAKI is a manifestation of COVID-19 (CoV-AKI). However, there is paucity of data from the United States, particularly from a predominantly black population. We report the phenotype and outcomes of AKI at an academic hospital in New Orleans.MethodsWe conducted an observational study in patients hospitalized at Ochsner Medical Center over a 1-month period with COVID-19 and diagnosis of AKI (KDIGO). We examined the rates of RRT and in-hospital mortality as outcome measures.ResultsAmong 575 admissions (70% black) with COVID-19 [173 (30%) to an intensive care unit (ICU)], we found 161 (28%) cases of AKI (61% ICU and 14% general ward admissions). Patients were predominantly men (62%) and hypertensive (83%). Median body mass index (BMI) was higher among those with AKI (34 versus 31 kg/m2, P<0.0001). AKI over preexisting CKD occurred in 35%. Median follow-up was 25 (1–45) days. The in-hospital mortality rate for the AKI cohort was 50%. Vasopressors and/or mechanical ventilation were required in 105 (65%) of those with AKI. RRT was required in 89 (55%) patients. Those with AKI requiring RRT (AKI-RRT) had higher median BMI (35 versus 33 kg/m2, P=0.05) and younger age (61 versus 68, P=0.0003). Initial values of ferritin, C-reactive protein, procalcitonin, and lactate dehydrogenase were higher among those with AKI; and among them, values were higher for those with AKI-RRT. Ischemic acute tubular injury (ATI) and rhabdomyolysis accounted for 66% and 7% of causes, respectively. In 13%, no obvious cause of AKI was identified aside from COVID-19 diagnosis.ConclusionsCoV-AKI is associated with high rates of RRT and death. Higher BMI and inflammatory marker levels are associated with AKI as well as with AKI-RRT. Hemodynamic instability leading to ischemic ATI is the predominant cause of AKI in this setting.

scholarly journals First person – Lauren Brilli Skvarca and Hwa Han

2019 ◽  
Vol 12 (4) ◽  
Keyword(s):  
Acute Kidney Injury ◽  
Research Training ◽  
Medical Center ◽  
Model Organism ◽  
Kidney Injury ◽  
Early Career ◽  
First Person ◽  
Cellular Mechanisms ◽  
University Of Pittsburgh ◽  
The University

ABSTRACT First Person is a series of interviews with the first authors of a selection of papers published in Disease Models & Mechanisms (DMM), helping early-career researchers promote themselves alongside their papers. Lauren Brilli Skvarca and Hwa Han are co-first authors on ‘Enhancing regeneration after acute kidney injury by promoting cellular dedifferentiation in zebrafish’, published in DMM. Lauren is a Pathologist Investigator Residency Research Training (PIRRT) Fellow at the University Pittsburgh Medical Center (UPMC), USA, in the lab of Carl Hubel, investigating maternal-fetal cell interactions contributing to placental vascular changes in preeclampsia and postpartum maternal cardiovascular risk. Hwa is a PhD graduate student in the lab of Neil Hukriede at the University of Pittsburgh School of Medicine, USA, and is involved in characterizing regenerative cellular mechanisms in gentamicin-induced acute kidney injury using larval zebrafish as a model organism.

scholarly journals A Multi-Center Retrospective Study of Clinical features, Laboratory Characteristics, and Outcomes of 325  Hospitalized Children with Coronavirus Disease 2019 (COVID-19); A Preliminary Report from Iranian Network for Research in Viral Diseases (INRVD)

2020 ◽  
Author(s):  
Iraj Sedighi ◽  
Alireza Fahimzad ◽  
Neda Pak ◽  
Mitra Khalili ◽  
Mohammad Reza Shokrollahi ◽  
...  
Keyword(s):  
Disease Severity ◽  
Clinical Features ◽  
Pediatric Patients ◽  
Clinical Laboratory ◽  
Cardiac Injury ◽  
Case Fatality ◽  
Kidney Injury ◽  
Research Network ◽  
Shortness Of Breath ◽  
Radiographic Appearance

Abstract Background: The objectives of this study were to analyze the clinical features and laboratory profiles and risk factors associated with critical illness of children with SARS-CoV-2.Methods: 325 COVID-19 pediatric patients were recruited through a collaborative research network between March and May 2020. Demographics, clinical, laboratory, and radiological results were obtained from patient files. Results: Of 325 patients, 189 (58%) and 136 (42%) were males and females, respectively. The mean age was 6.18 ± 4.99. 195 (60%) and 130 (40%), had moderate and severe conditions, respectively. 45 (13.9%) of patients died. The common symptoms were fever (72.6%), cough (59%) and shortness of breath (36%). 254 (78%) and 145 (44.6%( had gastrointestinal and neurological symptoms, respectively. Shortness of breath, rhinorrhea, nausea/vomiting, decrease in platelet counts; increase values in C-reactive protein, lactate dehydrogenase (LDH), and blood urea nitrogen, decrease in the blood PH and HCo3 were significantly associated with the disease severity. 58.2% and 65.4% of patients showed abnormal radiographic appearance in Chest X-ray and in chest CT scan, respectively, which were correlated with disease severity. 104 (32%) of patients referred to ICU. The coexistence of comorbidity was the main factor associated with ICU admission, shock, arrhythmia, acute kidney injury, acute respiratory distress syndrome (ARDS), acute cardiac injury, and death. Conclusions: We describe a higher than previously recognized rate of COVID-19 mortality in Iranian pediatric patients. Epidemiological factors, such as relatively high case fatality rate in the country and the presence of underlying diseases are the main factors for the high death rate.

scholarly journals Lipid Profile Features and Their Associations With Disease Severity and Mortality in Patients With COVID-19

2020 ◽  
Vol 7 ◽  
Author(s):  
Jia Teng Sun ◽  
Zhongli Chen ◽  
Peng Nie ◽  
Heng Ge ◽  
Long Shen ◽  
...  
Keyword(s):  
Lipid Profile ◽  
Disease Severity ◽  
Clinical Laboratory ◽  
Severe Disease ◽  
Density Lipoprotein ◽  
Strongly Correlated ◽  
Discrimination Ability ◽  
Reactive Protein ◽  
Low Hdl ◽  
Hospital Deaths

Background: Emerging studies have described and analyzed epidemiological, clinical, laboratory, and radiological features of COVID-19 patients. Yet, scarce information is available regarding the association of lipid profile features and disease severity and mortality.Methods: We conducted a prospective observational cohort study to investigate lipid profile features in patients with COVID-19. From 9 February to 4 April 2020, a total of 99 patients (31 critically ill and 20 severely ill) with confirmed COVID-19 were included in the study. Dynamic alterations in lipid profiles were recorded and tracked. Outcomes were followed up until 4 April 2020.Results: We found that high-density lipoprotein-cholesterol (HDL-C) and apolipoprotein A-1 (apoA-1) levels were significantly lower in the severe disease group, with mortality cases showing the lowest levels (p &lt; 0.0001). Furthermore, HDL-C and apoA-1 levels were independently associated with disease severity (apoA-1: odds ratio (OR): 0.651, 95% confidence interval (CI): 0.456–0.929, p = 0.018; HDL-C: OR: 0.643, 95% CI: 0.456–0.906, p = 0.012). For predicting disease severity, the areas under the receiver operating characteristic curves (AUCs) of HDL-C and apoA-1 levels at admission were 0.78 (95% CI, 0.70–0.85) and 0.85 (95% CI, 0.76–0.91), respectively. For in-hospital deaths, HDL-C and apoA-1 levels demonstrated similar discrimination ability, with AUCs of 0.75 (95% CI, 0.61–0.88) and 0.74 (95% CI, 0.61–0.88), respectively. Moreover, patients with lower serum concentrations of apoA-1 (&lt;0.95 g/L) or HDL-C (&lt;0.84 mmol/l) had higher mortality rates during hospitalization (log-rank p &lt; 0.001). Notably, levels of apoA-1 and HDL-C were inversely proportional to disease severity. The survivors of severe cases showed significant recovery of apoA-1 levels at the end of hospitalization (vs. midterm apoA-1 levels, p = 0.02), whereas the mortality cases demonstrated continuously lower apoA-1 levels throughout hospitalization. Correlation analysis revealed that apoA-1 and HDL-C levels were negatively correlated with both admission levels and highest concentrations of C-reactive protein and interleukin-6.Conclusions: Severely ill COVID-19 patients featured low HDL-C and apoA-1 levels, which were strongly correlated with inflammatory states. Thus, low apoA-1 and HDL-C levels may be promising predictors for severe disease and in-hospital mortality in patients suffering from COVID-19.

scholarly journals 1326. Possible Predictors of Coinfection in COVID-19: Making a Difficult Diagnosis

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S750-S751
Author(s):  
Christopher J Lehmann ◽  
Rohan N Shah ◽  
Mengqi Zhu ◽  
Natasha N Pettit ◽  
Jessica Ridgway ◽  
...  
Keyword(s):  
Disease Severity ◽  
Medical Center ◽  
Severe Disease ◽  
Kidney Injury ◽  
Resistant Organism ◽  
Multiple Drug ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Presenting Symptoms ◽  
Hospital Acquired

Abstract Background Coinfection with COVID-19 and a secondary pathogen contributes to morbidity and mortality. Despite its contribution to outcomes, diagnosing coinfection is challenging and no predictive tools have been established. To better assess risk factors for coinfection, we performed a review of all patients hospitalized for COVID-19 in our institution and evaluated them for candidate predictors of coinfection. Methods Medical records were reviewed in all patients admitted with COVID-19 at University of Chicago Medical Center between March 1, 2020 and April 18, 2020. Those identified as having coinfection were compared to those without coinfection. Secondary review was performed for characteristics of the coinfection, including diagnosis, microbiology, drug resistance, and nosocomial acquisition. Results 401 patients were included in the study, the mean age was 60 years (SD-17), 29% had severe disease, and 13% died. At least one test for coinfection was performed in 99% of patients. Coinfection was identified in 15% (72/401) of patients. Coinfection was associated with older age, disease severity, and hospital complications, such as DVT/PE, AKI, and delirium. [Table 1] No symptom, non-microbiologic test, radiograph, or preexisting condition was associated with coinfection. Dyspnea, chest pain, and obesity were more common in those without coinfection. 74% received antibiotics. The most common sites for coinfection were urinary 33%, lower respiratory 26%, and blood 24%. [Table2] Bacteria were most frequently recovered (82%). The most commonly recovered pathogens were Enterobacterales (42%), Staphylococcus aureus (12%), and Pseudomonas (4%). 42% of the infections were hospital acquired, 16% caused by MDRO, and 13% were catheter or ventilator associated. Table 1. Clinical Characteristics Associated with Coinfection Abbreviations: sd, standard deviation; WBC, white blood cell count; CRP, C-reactive protein; COPD, chronic obstructive pulmonary disease; ARDS, acute respiratory distress syndrome; DVT, deep venous thrombosis; PE, pulmonary embolism; MI, myocardial infarction; AKI, acute kidney injury Table 2. Characteristics of Coinfection Abbreviations: Cath, catheter; Vent, ventilator; Assoc, Associated; MDRO, Multiple Drug Resistant Organism Conclusion Coinfection in COVID-19 was most closely associated with age, COVID-19 disease severity, and complicated hospitalization. No presenting symptoms, non-microbiologic test, or radiograph was associated with coinfection, underscoring the challenge in diagnosing coinfection. A remarkable number of infections were hospital acquired, MDRO, and catheter/ventilator associated. Further prospective study on coinfection in COVID-19 is needed to guide diagnosis and treatment. Disclosures Renslow Sherer, MD, Gilead Sciences, Inc (Grant/Research Support)

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