Unmodified risk variables for nosocomial bloodstream infections (BSIs) included male sex and leukocytosis at admission. Using methylprednisolone and obtaining a cumulative dosage of dexamethasone were adjusted risk variables associated with superimposed nosocomial BSI in hospitalized patients with COVID-19. Therefore, the cornerstone of treatment is to choose the correct corticosteroid dose.

Furthermore, because nosocomial BSIs contribute to increasing hospital mortality, physicians should carefully consider the administration of methylprednisolone if there is no clear indication.

259 patients were screened during the study period of 2 years.

7 patients were excluded because of community BSIs (4 cases), referral within 24 h (2 cases), and need for end-of-life care with death within 24 h (1 case).

Overall, 252 patients were included in the analysis, and 48 patients (19%) developed nosocomial BSIs.

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