bluuebunny/crossref_metadata_2025_split huggingface dataset:
P-1900. Temporal Course and Risk Factors of Coinfections in Patients Hospitalized for COVID-19
Authors: Vilkas James L , Akmal Ali , Sarwar Akmal , Lei Yuxiu , Liesching Timothy N 
Published: January 2025

Abstract

Background
Studies about the distinction between coinfections acquired prior to admission and hospital-acquired coinfections and risk factors at different time point are limited.

Methods
We reviewed microbiology laboratory data of patients hospitalized for COVID-19 viral infection during January 1, 2024 to March 13, 2024.

Results
We collected data on 75 patients. The temporal course of coinfection rate was: 9.3% on the same day of hospital admission (Day 1); 10.7% on Day 2 to Day 4; 2.7% on Day 5 to Day 9; 14.7% after Day 9 . At any time point prior to or during the hospitalization or rehospitalization, 23 (30.7%) patients acquired infection of at least one organism.
Univariate analysis showed younger age (69 years vs. 78 years, p=0.025), lower proportion of diabetic patients (17.4% vs. 44.2%, p=0.036), lower proportion of chronic kidney disease (17.4% vs. 40.4%, p=0.065), higher proportion of indwelling catheter (17.4% vs. 1.9%, p=0.029), higher proportion of cancer (34.8% vs.13.5%, p=0.057), similar prior antibiotics (43.5% vs. 36.5%, p=0.6), and significant higher proportion of prior corticosteroids (21.7% vs. 3.9%, p=0.025) in coinfected group than not-coinfected group. Multivariate analysis indicated that indwelling catheter at baseline (OR=45.8, 95%CI: 3.2-652.8, p=0.005) and prior corticosteroids (OR=17.1, 95%CI: 0.99-296.4, p=0.051) are the two independent risk factors for coinfection at admission. Younger age (OR=0.96, 95%CI: 0.918-1.000, p=0.0495) and prior corticosteroids (OR=52.6, 95%CI: 3.11-891.3, p=0.006) are the two independent risk factors for hospital-acquired coinfection.

Conclusion
About 10% of patients hospitalized for COVID-19 infection had coinfection(s) at admission, with Escherichia coli being the most common. The coinfections at admission were eradicated within eight days. The second wave of coinfection(s) acquired during hospitalization rose to about 15% after eight days, with Klebsiella being the most common. Patients with indwelling catheter or prior corticosteroids use are in much greater risk to be coinfected with COVID-19 before hospital admission. Patients with prior corticosteroids are at fifty-time higher risk for hospital-acquired coinfections.

Disclosures
All Authors: No reported disclosures
P-1901. Statin Use and Severe/Critical/Fatal Outcomes in Individuals with COVID-19
Authors: Butt Adeel A , Yan Peng , Shaikh Obaid 
Published: January 2025

Abstract

Background
There are conflicting results regarding the effects of statins upon outcomes in individuals with COVID-19. Several studies demonstrated a beneficial effect on survival, with others failing to demonstrate a beneficial effect, or even a higher risk of mortality, need for mechanical ventilation, and intensive care unit admissions among those who received statins.
Statins in COVID_Fig 1

Methods
We identified all individuals in the VA COVID-19 database with confirmed COVID-19. We excluded those with HIV, organ transplantation, cancer diagnosis, and any hospitalization within preceding 30 days. Among those, we created a pool of potential cases who had received a statin within +/- 7 days, and controls with no statins in the previous 365 days and up to 28 days after the index positive test date. Using an inverse probability of treatment weights (IPTW) based approach, we determined the rates of moderate/severe/critical disease within 28 days of the index COVID-19 diagnosis among statin-recipients and controls. Absolute risk differences (ARD) and Kaplan-Meier curves were generated for cases and controls.
Statins in COVID_Fig 2

Results
In IPTW-weighted matched analysis including 10,544 statin-recipients and 94,185 controls, statin-recipients were more likely to have an unfavorable outcome compared with controls (ARD 0.21 (95% CI 0.08,0.35) overall. In subgroup analyses, statin-recipients &gt;60 years old and those with diabetes, cardiovascular disease, or chronic lung or kidney disease had more favorable outcomes compared with controls.

Conclusion
Individuals with COVID-19 who received statins were more likely to have poorer outcomes compared with controls not receiving statins. Subgroup analyses demonstrating a benefit among those at high risk of cardiovascular outcomes may be reflection of the beneficial effects of statins on the underlying comorbidities rather than a direct benefit against COVID-19.

Disclosures
Adeel A. Butt, MD, MS, Gilead Sciences: Grant/Research Support
P-1902. Routine Anti-Nuclear Antibody (ANA) Testing in Patients Experiencing Long COVID: Worth it?
Authors: Ghorbani Abigail , Strong Nora , Keller MaryJane , Ostrosky-Zeichner Luis 
Published: January 2025

Abstract

Background
Patients with long COVID are often tested for ANA as part of their routine work-up (Son et al., 2023). However, it is unclear if this testing leads to a rheumatological diagnosis or is actionable. This project assessed the frequency of ANA-positivity in patients experiencing long COVID and the outcomes of rheumatic disease diagnosis and treatment.

Methods
Electronic medical records (EMR) from January 2022 through May 2023 at the UT Physicians COVID Center of Excellence were reviewed. The population included those experiencing long COVID and presenting with symptoms. Symptoms, personal and family history of rheumatic disease, last known COVID date, ANA test results, referral to rheumatology, diagnoses, and treatment, if any, were recorded. Data was analyzed using Microsoft Excel PivotTables and JavaStat, with right-tailed Fisher Exact Tests.

Results
The 117-patient sample was 76.92% female, with an average age of 49.21+/-15.09 SD years, with last known COVID between March 2020 and February 2023. 17.95% had a previous rheumatic diagnosis, and 22.22% had a family history of rheumatic disease. The symptoms reported were: fever (6.84%), arthralgia (43.59%), arthritis (22.22%), rash (23.08%), and fatigue (79.49%). 75.21% of patients received an ANA test, of which 43.18% were positive. The mode titer was 1:80, and the most common pattern was nuclear. 48.72% of the patients with a positive test were referred to rheumatology, but only 21.05% received a rheumatological diagnosis. Only 11.97% received any treatment for their symptoms, and most treatments were for symptom control or an anti-inflammatory. On the last visit, only 2.56% had resolution of long COVID symptoms. None of the symptoms were predictive of a positive ANA test.

Conclusion
The majority of patients experiencing long COVID presenting to our clinic received an ANA test, and almost half had a positive result. Few received any rheumatological diagnosis and most had ongoing symptoms by their latest visit. Although this study is limited by sample size, bias in ANA ordering, and its retrospective nature, these data suggest that routine ANA testing and rheumatology referrals may not be cost-effective in patients experiencing long COVID.

Disclosures
Luis Ostrosky-Zeichner, MD, FACP, FIDSA, FSHEA, FECMM, CMQ, Cidara: Advisor/Consultant|Enanta: Advisor/Consultant|F2G: Advisor/Consultant|Gilead: Advisor/Consultant|GSK: Advisor/Consultant|Melinta: Advisor/Consultant|Octapharma: Advisor/Consultant|Pfizer: Advisor/Consultant|Pfizer: Grant/Research Support|Pulmocide: Grant/Research Support|Scynexis: Grant/Research Support|Viracor: Advisor/Consultant
646. Clinical and microbiological outcomes of omadacycline for pulmonary Mycobacterium abscessus complex
Authors: Al Musawa Mohammed , Vemula Raaga , Mammadova Mehriban , Wadle Carly , Muscarella Anahit , Cimino Christo , Zeuli John , Howard Catessa A , Butt Saira , Mejia-Chew Carlos , Hamad Yasir , Ong Aaron , Cohen Keira A , Kaip Emily A , Tupayachi-Ortiz Maria G , Fiske Christina T , Judd Chloe , Caniff Kaylee E , Rybak Michael J 
Published: January 2025

Abstract

Background
Mycobacterium abscessus complex (MABC) is a difficult-to-treat infection due to antibiotic resistance. Our study aimed to assess omadacycline’s (OMC) clinical and microbiological outcomes for the treatment of pulmonary MABC.

Methods
A retrospective study was carried out across 12 US medical institutions from 1/2018-4/2023 to examine the clinical outcomes, and tolerability of OMC treatment for pulmonary MABC. Patients aged ≥ 18 years who were treated with OMC for ≥ 3 months were included. The primary outcome was clinical success at 3, 6, and 12 months. The secondary outcomes were sputum culture conversion rate, adverse effects, and clinical success by subspecies and macrolide susceptibility.

Results
Thirty-five patients were included in this analysis. Most patients were female (74.3%) and Caucasian (74.3%), with a median (IQR) age of 61 years (51–70). Subspeciation was performed for 22 isolates with predominant M. abscessus subspecies (77.3%). Moreover, coinfection with other NTM species was present in 28.6% of cases where Mycobacterium avium complex was present in 8 cultures. Sixty-eight percent of the MABC isolates were confirmed to be macrolide resistance; half (12/24, 50.0%) were evident by the presence of functional erm gene, while the other half by antimicrobial susceptibility (Table 3). Of the remaining isolates, 14% were macrolide-susceptible, while no information was reported in 17%. The median (IQR) treatment duration of OMC was 8 months (3.9 – 15.7). The most commonly co-administered antibiotics were intravenous amikacin, imipenem/cilastatin, inhaled amikacin and clofazimine with the same percentage (42.9%) (Table 1). Overall, MABC clinical success was observed in 71.4%, 89.7%, and 90.9% in 3-, 6- and 12 months, respectively (Table 3). Adverse effects reported in 34.3%. The most common side effects were gastrointestinal intolerance (25.7%) and hepatoxicity (11.4%), which led to drug discontinuation in 22.9%.

Conclusion
OMC treatment showed clinical success in &gt; 70% of patients with pulmonary MABC including patients with macrolide resistant strains for more than 3 months. However, larger studies are needed to validate the outcomes beyond 12 months.

Disclosures
Kaylee E. Caniff, PharmD, BCIDP, T2Biosystems: Honoraria Michael J. Rybak, PharmD, PhD, MPH, Abbvie, Melinta, Sionogi, Merck, T2Biosystems: Advisor/Consultant|Abbvie, Melinta, Sionogi, Merck, T2Biosystems: Grant/Research Support|Abbvie, Melinta, Sionogi, Merck, T2Biosystems: Speaker
P-1958. Impact of COVID-19 on Acute Diverticulitis: Evidence of United States Hospitals in 2020
Authors: Suenghataiphorn Thanathip , Lohawatcharagul Tuntanut , Danpanichkul Pojsakorn , Thongpiya Jerapas , Polpichai Natchaya , Kulthamrongsri Narathorn , Tangsirisatian Ponphisudti , Sasipong Nuttarak , Wattanachayakul Phuuwadith 
Published: January 2025

Abstract

Background
Acute diverticulitis, a prevalent gastrointestinal condition, frequently necessitates hospitalization and is associated with potential adverse in-hospital outcomes. Recent data showed the detrimental effects of COVID-19 infection on acute diverticulitis, particularly in patients with severe COVID-19 infections. However, limited information exists on the specific impacts of COVID-19 infection in patients hospitalized for acute diverticulitis.

Methods
We analyzed the 2020 U.S. National Inpatient Sample (NIS) to investigate the effects of COVID-19 infection on cases primarily admitted due to acute diverticulitis. Participants aged 18 and above were identified using relevant ICD-10 CM codes. Adjusted odds ratios (aORs) for specified outcomes were calculated through multivariable logistic and linear regression analyses. The primary outcome was inpatient mortality, with secondary outcomes including system-based complications. Statistical significance was established at a P value of 0.05.

Results
We identified 167,170 patients with a primary discharge diagnosis of acute pancreatitis. The mean age was 60.1 years; 56.8% were female. Caucasians accounted for the majority, followed by Hispanics. Of these, 0.90% (1,504/167,170) had a concurrent diagnosis of COVID-19 infection.
In a survey multivariable logistic and linear regression model adjusting for patient and hospital factors, COVID-19 infection was associated with higher in-hospital mortality (aOR 8.43; 95% CI 4.32, 16.42, P &lt; 0.001), prolonged length of stay (β LOS 2.02; 95% CI 1.27, 2.77, P &lt; 0.001) and increased hospitalization charge ( β charge 17,813.27; 95% CI 4,080, 31,546, P &lt; 0.001), We observed non-significant, but increased, risks of shock, acute kidney injury (AKI), acute respiratory distress syndrome (ARDS), and mechanical ventilation in COVID-19 positive patients.

Conclusion
In conclusion, our study revealed that COVID-19 infection is associated with higher in-hospital mortality, prolonged hospital stays, and increased hospitalization charges in patients diagnosed with acute diverticulitis. Future longitudinal studies are warranted to comprehensively assess the long-term health sequelae in this population.

Disclosures
All Authors: No reported disclosures
P-1961. Epidemiologic analysis of an alpha variant COVID-19 nosocomial cluster that occurred after completed vaccination of healthcare workers
Authors: Kawamura Hideki , Nakano Koji , Hanada Norihisa , Sameshima Koji 
Published: January 2025

Abstract

Background
In a field where few reports have been made on the efficacy of SARS-CoV-2 vaccines in healthcare settings. We experienced an outbreak of an alpha variant in a medical institution cluster after healthcare workers were vaccinated, providing a novel perspective on the topic.Figure 1.Epidemic curve based on the day of positive SARS-CoV-2 PCR test (A) or on the symptom onset day (B) during this COVID-19 outbreak
The index case was a patient admitted to the hospital on 24 May. The last positive case was detected ten days after the first detection, but 42 patients, including five asymptomatics and three healthcare workers, including an asymptomatic, were infected.

Methods
We conducted descriptive epidemiology from case detection in the cluster of medical institutions with the alpha variant in June 2021. We also compared the relationship between vaccination status and infection using the Fisher exact test for healthcare workers in the same period.Figure 2.Diagram of hospital room layouts for patients infected in the first wave (through June 1)
We confirmed infected inpatients in a wide range of hospital rooms.

Results
We identified one healthcare worker as a first test-positive case on 4 Jun 2021, and 21 positive patients were identified by screening on the day of detection and the following day. Based on the descriptive epidemiological analysis, the index case was a patient admitted to the hospital on 24 May with pneumonia treated with NPPV in an independently air-conditioned negative pressure room from the third day of admission. The last positive case was detected 10 days after first detection, but 42 patients and three healthcare workers were infected (Figure 1).
Forty-two of 88 hospitalized patients (53.7%) and 3 of 38 healthcare workers (7.9%) were infected. There were no cases of infection among the 30 healthcare workers who had completed the 2-dose vaccination, and the infection rate was significantly lower than that of the staff members who had not completed the vaccination (0% (0/30) vs. 37.5% (3/8), p=0.008). No hospitalized patients had completed the 2-dose vaccination, including infected and uninfected cases. Aerosol transmission from initial cases, the patient-to-patient droplet route, and the hospital ward contact route were considered factors in the spread of the disease (Figure 2 and Figure 3).Figure 3.Links within the cluster
Aerosol transmission from initial cases, the patient-to-patient droplet route, and the hospital ward contact route were considered factors in the spread of the disease.

Conclusion
Our study not only underscores the importance of strict adherence to standard precautions, early detection of infected cases, and implementation of route-specific prophylaxis but also highlights the crucial role of vaccination in preventing the outbreak and spread of COVID-19 clusters in medical institutions.

Disclosures
All Authors: No reported disclosures
P-1990. Out-of-Hospital Care Setting in a Febrile Emergency Unit of Suspected Covid 19 Patients
Authors: Guglielmo María Cecilia , Aprea Valeria , Guedes Veronica , Debaisi Gustavo , Puleio Liliana Yazde , Miño Laura 
Published: January 2025

Abstract

Background
In 2019, a new infection was reported in China. This coronavirus was named SARS-COV-2, causative of the 21st-century pandemic, COVID-19. Health systems adopted different strategies to cope with it.

Objective
to describe the clinical-epidemiological characteristics of COVID-19 in children seen at an Emergency Febril Unit (UFU). Demographic and epidemiological characteristics of children treated at EFU of Pedro de Elizalde Children's Hospital (n = 952)

Methods
Cross-sectional study in patients under 18 years of age tested for SARS-COV-2 between April 1 and June 30, 2020. All epidemiological records made at the time of consultation and the result of the Polymerase Chain Reaction (PCR) test of these patients, either by suspicion of COVID-19 or epidemiological isolation criteria, were included. Patients whose samples had been taken for SARS-COV-2 determination outside the initial time of consultation or whose epidemiological records were incomplete or did not meet the established inclusion criteria were excluded. The diagnosis of COVID-19 was made using the PCR technique for SARS-COV-2 in nasopharyngeal secretions obtained by nasopharyngeal swab or aspirate. The following variables were recorded: age, gender, place of residence, history of close contact, history of history of close contacts, travel history and comorbidities, history of institutionalization and PCR result.
Presentation of symptoms: Frequency

Results
1,104 patients were admitted to the UFU and tested due to suspected COVID-19. 152 patients had to be excluded due to insufficient data. Of the 952 patients tested, 22.6% had a detectable result, and 71.2% of them reported close contact with confirmed cases. The mean age was 5.9 years. The 55.4% were male and 99.3% lived in the Metropolitan Area of Buenos Aires. 72.8% of the patients tested had symptoms. The time of delay in consultation was 2.17 days. 25% of the children had comorbidities.

Conclusion
The availability of the UFU facilitated access and optimized the care circuit in response to demand. Children with a history of close contact and those symptomatic showed more frequently a detectable result for SARS-COV-2.

Disclosures
All Authors: No reported disclosures
P-1994. Rapid COVID-19 Transmission and Multi-layered Interventions in a High-rise Detention Center from January to March 2022 in South Korea
Authors: Song Jin Su , Choe Pyoeng Gyun , Park Wan Beom , Lee Shin Young , Yi Seonju 
Published: January 2025

Abstract

Background
Correctional and detention facilities face significant challenges in controlling the spread of highly infectious pathogens such as SARS-CoV-2 due to overcrowded conditions, inadequate ventilation, and shared facilities. Despite reports on COVID-19 outbreaks in various correctional settings worldwide, investigations into outbreaks in metropolitan high-rise prisons remain scarce, warranting detailed examination.
Diagnosed cases of coronavirus diseases 2019 (COVID-19) in detention center (blue) and South Korea (yellow), January through March 2022

Methods
The detention center, which covers an area of 41,658 mm2, can accommodate 2,070 individuals and housed 1,977 inmates and 674 correctional officers at the time of outbreak detection. The facility comprises five buildings, including one 10-story and four 12-story buildings, with 47 wards. Each building is connected with the following building through a common hallway located at the distal end of each building. Descriptive analyses were conducted on demographic characteristics, symptom onset dates, comorbidities, vaccination status, and exposure history of confirmed COVID-19 cases. Vaccine effectiveness was estimated using logistic regression models.
Epidemic curve of SARS-CoV-2 case-patients by building and floor(vertical axis), South Korea, 2022

Results
From January 25 to March 2, 2022, 492 people, including 474 (30.0%) of 1,977 incarcerated persons (cumulative attack rate of 24%) and 18 (2.7%) of 674 staff members at the detention center, were confirmed with SARS-CoV-2 infection. High-rise facility characteristics contributed to rapid transmission, with the index case identified on January 25, 2022. However, the implementation of physical distancing, decarceration, limiting movement, and conducting serial and mass testing, despite being complex and requiring substantial resources, effectively slowed the spread of the Omicron variant amidst persistent community transmission. Vaccine effectiveness against infection was estimated at 52.7% (95% confidence interval, 37.2% to 64.4%) for three doses.
Characteristics of coronavirus disease 2019 case-patients in a detention center, South Korea, 2022

Conclusion
The findings underscore the vulnerability of high-rise detention centers to COVID-19 outbreaks and emphasize the effectiveness of multi-layered interventions in curbing transmission. Swift and comprehensive measures are crucial for controlling outbreaks in high-density, enclosed settings, informing future pandemic response efforts and policy development.

Disclosures
All Authors: No reported disclosures