Infections, primarily those resulting from multi-drug resistant bacteria, are a leading cause of increased morbidity and mortality among patients with cirrhosis. It is essential to understand that the COVID-19 pandemic has potentially influenced the infection patterns in these patients due to various restrictive measures in place globally. The following study aims to highlight and compare infection scenarios in these patients before and within the ongoing COVID-19 pandemic. Hospitalizations of patients with cirrhosis from March 2019 to February 2021 were analyzed retrospectively, examining factors such as patient baseline characteristics, infection types, bacterial strains, levels of antimicrobial resistance, and mortality rates. A noticeable decline in hospitalizations was observed during the pandemic.
The infection incidence remained largely the same in both periods analyzed, however a trend towards lower nosocomial infection rates coupled with a higher occurrence of multi-drug resistant organism (MDRO) infections was observed during the pandemic. Patients with cirrhosis are highly susceptible to bacterial infections due to impairments in the immune system and repeat invasive procedures.
The viral outbreak of COVID-19 in 2019 rapidly escalated into a global public health crisis demanding immediate changes to healthcare practices, including the widespread adoption of physical distancing, personal protective equipment, hand hygiene measures, travel restrictions, and telemedicine, which could all influence bacterial infection patterns. The study revealed a non-significant decline in MDRO infections during the pandemic, conflicting with previous reports. In conclusion, the incidence of infections in cirrhotic patients remained relatively stable during the COVID-19 pandemic. However, a significant shift was observed in the elements of infection, leading to a decrease in nosocomial infections but increased MDRO infections.