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J Clin Med . Clinical Outcomes and Prolonged SARS-CoV-2 Viral Shedding in ICU Patients with Severe COVID-19 Infection and Nosocomial Bacterial Pneu

tetano

Editor, Senior Moderator
J Clin Med


. 2022 Nov 17;11(22):6796.
doi: 10.3390/jcm11226796.
Clinical Outcomes and Prolonged SARS-CoV-2 Viral Shedding in ICU Patients with Severe COVID-19 Infection and Nosocomial Bacterial Pneumonia: A Retrospective Cohort Study


Chuan-Yen Sun[SUP] 1 [/SUP], Jia-Yih Feng[SUP] 1 2 [/SUP], Jhong-Ru Huang[SUP] 1 [/SUP], Hisao-Chin Shen[SUP] 1 [/SUP], Yuh-Min Chen[SUP] 1 2 [/SUP], Wei-Chih Chen[SUP] 1 2 3 [/SUP], Kuang-Yao Yang[SUP] 1 2 3 4 [/SUP]



Affiliations
Free article

Abstract

Objectives: This study explored the clinical outcomes and association of prolonged severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) shedding in patients with severe coronavirus disease 2019 (COVID-19) infection who developed nosocomial pneumonia.
Methods: This was a retrospective study conducted in a medical center in Taiwan. From May to September 2021, patients from four intensive care units were enrolled after SARS-CoV-2 was confirmed through quantitative polymerase chain reaction and all cases were compatible with the definitions of severe COVID-19 infection. Baseline characteristics, disease severity, clinical outcomes, and times of viral shedding were recorded.
Results: A total of 72 patients were diagnosed as having severe COVID-19 infection and 30 developed nosocomial pneumonia, comprising hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP). The patients with severe COVID-19 infection and concomitant HAP/VAP had longer intensive care unit (ICU) stays and fewer ventilator-free days at Day 28. An independent risk factor for nosocomial pneumonia was a greater SOFA score at admission. Furthermore, the patients with severe COVID-19 infection who developed HAP/VAP had a significantly longer duration of SARS-CoV-2 shedding (19.50 days vs. 15.00 days, p = 0.006).
Conclusions: Patients with severe COVID-19 infection who developed nosocomial pneumonia had longer SARS-CoV-2 shedding days, more complications, and worse outcomes.

Keywords: coronavirus disease 2019; prolonged viral shedding; secondary pneumonia; severe acute respiratory syndrome coronavirus 2.
 
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