a large-scale retrospective study on the prevalence of covid-19 and urinary bacterial coinfections among hospitalized patients in salmas, northwest iran

Background: the covid-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2, started with an outbreak of covid-19 in wuhan, china, in december 2019, resulting in millions of deaths in the following years. bacterial coinfections and superinfections are concerns for patients with covid-19. this study aimed to determine the mortality rate of covid-19, its associated risk factors, and the bacterial isolates from urine samples of hospitalized patients suspected of having covid-19 in salmas, northwest iran. methods: the data from 3,733 patients suspected of covid-19 who were referred to khatam al-anbiya hospital in salmas, west azerbaijan, northwest iran, from december 2019 to february 2024, were collected and analyzed in a retrospective study.results: of the 3,733 patients, 2,172 (58.2%) tested positive for covid-19, while 1,561 (41.8%) tested negative. among those who tested positive, 1,210 were females (59.6%), and 962 were males (56.5%). the highest covid-19 rate was observed in 2021 (72%), whereas the lowest rate was reported in 2024 (13.8%). of the covid-19-positive patients, 328 (15.1%) died, and the bacterial isolates from their urine samples included escherichia coli (68.75%), which was the most prevalent isolate, followed by klebsiella spp. (12.5%), coagulase-negative staphylococci spp. (10%), enterobacter spp. (3.75%), nonhemolytic streptococci spp. (2.5%), pseudomonas aeruginosa (1.25%), and streptococcus beta-hemolytic spp. (1.25%). conclusion: based on the results, the overall mortality rate of covid-19 over five years was 15.1%. the most important risk factors for covid-19-related death included older age, chronic kidney and lung diseases, diabetes mellitus, and male gender. bacterial isolates from the urine samples of covid-19 patients were e. coli, klebsiella spp., coagulase-negative staphylococci spp., p. aeruginosa, enterobacter spp., and non-hemolytic streptococci spp.