<i>Clostridioides Difficile</i> Co-Infection in Patients with COVID-19

Abstract

<b>Aim:</b> To assess the impact of <i>Clostridioides difficile</i> infection on the course of COVID-19. <b>Methods:</b> The authors included 809 patients with COVID-19 in this retrospective study: 55 had <i>C. difficile</i> infection, 23 had <i>C. difficile</i>-negative antibiotic-associated diarrhea and 731 had no diarrhea. <i>C. difficile</i> in feces was determined by immunochromatographic test for its toxins. <b>Results:</b><i>C. difficile</i> infection was associated with increased risk of death (hazard ratio = 2.6; p = 0.021), especially after 20 days of disease (hazard ratio = 6.5; p < 0.001). <i>C. difficile</i> infection-associated diarrhea was longer and more severe than <i>C. difficile</i>-negative antibiotic-associated diarrhea. Unlike patients with <i>C. difficile</i>-negative antibiotic-associated diarrhea, patients with <i>C. difficile</i> infection were admitted to the intensive care unit and needed mechanical ventilation more often than those without diarrhea. <b>Conclusion:</b><i>C. difficile</i> infection worsens the course and prognosis of COVID-19.