Incidence, Risk Factors and Outcome of Suspected Central Venous Catheter-related Infections in Critically Ill COVID-19 Patients: A Multicenter Retrospective Cohort Study

Jasper M Smit, Lotte Exterkate, Arne J van Tienhoven, Mark E Haaksma, Micah L A Heldeweg, Lucas Fleuren, Patrick Thoral, Tariq A Dam, Leo M A Heunks, Diederik Gommers, Olaf L Cremer, Rob J Bosman, Sander Rigter, Evert-Jan Wils, Tim Frenzel, Alexander P Vlaar, Dave A Dongelmans, Remko de Jong, Marco Peters, Marlijn J A KampsDharmanand Ramnarain, Ralph Nowitzky, Fleur G C A Nooteboom, Wouter de Ruijter, Louise C Urlings-Strop, Ellen G M Smit, D Jannet Mehagnoul-Schipper, Tom Dormans, Cornelis P C de Jager, Stefaan H A Hendriks, Sefanja Achterberg, Evelien Oostdijk, Auke C Reidinga, Barbara Festen-Spanjer, Gert B Brunnekreef, Alexander D Cornet, Walter van den Tempel, Age D Boelens, Peter Koetsier, Judith Lens, Harald J Faber, A Karakus, Robert Entjes, Paul de Jong, Thijs C D Rettig, Sesmu Arbous, Bas Vonk, Tomas Machado, Armand R J Girbes, Elske Sieswerda, Paul W G Elbers, Pieter R Tuinman

Research output: Contribution to journalArticleAcademicpeer-review


Background: Aims of this study were to investigate the prevalence and incidence of catheter-related infection, identify risk factors, and determine the relation of catheter-related infection with mortality in critically ill COVID-19 patients. Methods: This was a retrospective cohort study of central venous catheters (CVCs) in critically ill COVID-19 patients. Eligible CVC insertions required an indwelling time of at least 48 hours and were identified using a full-admission electronic health record database. Risk factors were identified using logistic regression. Differences in survival rates at day 28 of follow-up were assessed using a log-rank test and proportional hazard model. Results: In 538 patients, a total of 914 CVCs were included. Prevalence and incidence of suspected catheter-related infection were 7.9% and 9.4 infections per 1,000 catheter indwelling days, respectively. Prone ventilation for more than 5 days was associated with increased risk of suspected catheter-related infection; odds ratio, 5.05 (95% confidence interval 2.12-11.0). Risk of death was significantly higher in patients with suspected catheter-related infection (hazard ratio, 1.78; 95% confidence interval, 1.25-2.53). Conclusions: This study shows that in critically ill patients with COVID-19, prevalence and incidence of suspected catheter-related infection are high, prone ventilation is a risk factor, and mortality is higher in case of catheter-related infection.

Original languageEnglish
Pages (from-to)358-365
Number of pages8
Issue number5
Early online date8 Sept 2022
Publication statusPublished - 1 Nov 2022


  • COVID-19
  • Central venous catheters
  • catheter-related infections
  • intensive care

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