tetano
Editor, Senior Moderator
J Clin Med
. 2021 Feb 3;10(4):555.
doi: 10.3390/jcm10040555.
Incidence and Prognosis of Ventilator-Associated Pneumonia in Critically Ill Patients with COVID-19: A Multicenter Study
Daniele Roberto Giacobbe[SUP] 1 [/SUP], Denise Battaglini[SUP] 2 [/SUP], Elisa Martina Enrile[SUP] 2 3 [/SUP], Chiara Dentone[SUP] 1 [/SUP], Antonio Vena[SUP] 1 [/SUP], Chiara Robba[SUP] 2 3 [/SUP], Lorenzo Ball[SUP] 2 3 [/SUP], Michele Bartoletti[SUP] 4 [/SUP], Irene Coloretti[SUP] 5 [/SUP], Stefano Di Bella[SUP] 6 [/SUP], Antonio Di Biagio[SUP] 1 7 [/SUP], Iole Brunetti[SUP] 2 [/SUP], Malgorzata Mikulska[SUP] 1 7 [/SUP], Novella Carannante[SUP] 8 [/SUP], Andrea De Maria[SUP] 1 7 [/SUP], Laura Magnasco[SUP] 1 7 [/SUP], Alberto Enrico Maraolo[SUP] 9 [/SUP], Michele Mirabella[SUP] 1 7 [/SUP], Giorgia Montrucchio[SUP] 10 11 [/SUP], Nicol? Patroniti[SUP] 2 3 [/SUP], Lucia Taramasso[SUP] 1 [/SUP], Giusy Tiseo[SUP] 12 [/SUP], Giacomo Fornaro[SUP] 4 [/SUP], Fiorentino Fraganza[SUP] 13 [/SUP], Luca Monastra[SUP] 13 [/SUP], Erik Roman-Pognuz[SUP] 6 14 [/SUP], Giacomo Paluzzano[SUP] 6 [/SUP], Giuseppe Fiorentino[SUP] 15 [/SUP], Antonio Corcione[SUP] 16 [/SUP], Linda Bussini[SUP] 4 [/SUP], Renato Pascale[SUP] 4 [/SUP], Silvia Corcione[SUP] 17 [/SUP], Tommaso Tonetti[SUP] 18 [/SUP], Matteo Rinaldi[SUP] 4 [/SUP], Marco Falcone[SUP] 12 [/SUP], Emanuela Biagioni[SUP] 5 [/SUP], Vito Marco Ranieri[SUP] 18 [/SUP], Maddalena Giannella[SUP] 4 [/SUP], Francesco Giuseppe De Rosa[SUP] 17 [/SUP], Massimo Girardis[SUP] 5 [/SUP], Francesco Menichetti[SUP] 12 [/SUP], Pierluigi Viale[SUP] 4 [/SUP], Paolo Pelosi[SUP] 2 3 [/SUP], Matteo Bassetti[SUP] 1 7 [/SUP]
Affiliations
Abstract
The primary objective of this multicenter, observational, retrospective study was to assess the incidence rate of ventilator-associated pneumonia (VAP) in coronavirus disease 2019 (COVID-19) patients in intensive care units (ICU). The secondary objective was to assess predictors of 30-day case-fatality of VAP. From 15 February to 15 May 2020, 586 COVID-19 patients were admitted to the participating ICU. Of them, 171 developed VAP (29%) and were included in the study. The incidence rate of VAP was of 18 events per 1000 ventilator days (95% confidence intervals [CI] 16-21). Deep respiratory cultures were available and positive in 77/171 patients (45%). The most frequent organisms were Pseudomonas aeruginosa (27/77, 35%) and Staphylococcus aureus (18/77, 23%). The 30-day case-fatality of VAP was 46% (78/171). In multivariable analysis, septic shock at VAP onset (odds ratio [OR] 3.30, 95% CI 1.43-7.61, p = 0.005) and acute respiratory distress syndrome at VAP onset (OR 13.21, 95% CI 3.05-57.26, p < 0.001) were associated with fatality. In conclusion, VAP is frequent in critically ill COVID-19 patients. The related high fatality is likely the sum of the unfavorable prognostic impacts of the underlying viral and the superimposed bacterial diseases.
Keywords: COVID-19; SARS-CoV-2; VAP; coronavirus; ventilation.
. 2021 Feb 3;10(4):555.
doi: 10.3390/jcm10040555.
Incidence and Prognosis of Ventilator-Associated Pneumonia in Critically Ill Patients with COVID-19: A Multicenter Study
Daniele Roberto Giacobbe[SUP] 1 [/SUP], Denise Battaglini[SUP] 2 [/SUP], Elisa Martina Enrile[SUP] 2 3 [/SUP], Chiara Dentone[SUP] 1 [/SUP], Antonio Vena[SUP] 1 [/SUP], Chiara Robba[SUP] 2 3 [/SUP], Lorenzo Ball[SUP] 2 3 [/SUP], Michele Bartoletti[SUP] 4 [/SUP], Irene Coloretti[SUP] 5 [/SUP], Stefano Di Bella[SUP] 6 [/SUP], Antonio Di Biagio[SUP] 1 7 [/SUP], Iole Brunetti[SUP] 2 [/SUP], Malgorzata Mikulska[SUP] 1 7 [/SUP], Novella Carannante[SUP] 8 [/SUP], Andrea De Maria[SUP] 1 7 [/SUP], Laura Magnasco[SUP] 1 7 [/SUP], Alberto Enrico Maraolo[SUP] 9 [/SUP], Michele Mirabella[SUP] 1 7 [/SUP], Giorgia Montrucchio[SUP] 10 11 [/SUP], Nicol? Patroniti[SUP] 2 3 [/SUP], Lucia Taramasso[SUP] 1 [/SUP], Giusy Tiseo[SUP] 12 [/SUP], Giacomo Fornaro[SUP] 4 [/SUP], Fiorentino Fraganza[SUP] 13 [/SUP], Luca Monastra[SUP] 13 [/SUP], Erik Roman-Pognuz[SUP] 6 14 [/SUP], Giacomo Paluzzano[SUP] 6 [/SUP], Giuseppe Fiorentino[SUP] 15 [/SUP], Antonio Corcione[SUP] 16 [/SUP], Linda Bussini[SUP] 4 [/SUP], Renato Pascale[SUP] 4 [/SUP], Silvia Corcione[SUP] 17 [/SUP], Tommaso Tonetti[SUP] 18 [/SUP], Matteo Rinaldi[SUP] 4 [/SUP], Marco Falcone[SUP] 12 [/SUP], Emanuela Biagioni[SUP] 5 [/SUP], Vito Marco Ranieri[SUP] 18 [/SUP], Maddalena Giannella[SUP] 4 [/SUP], Francesco Giuseppe De Rosa[SUP] 17 [/SUP], Massimo Girardis[SUP] 5 [/SUP], Francesco Menichetti[SUP] 12 [/SUP], Pierluigi Viale[SUP] 4 [/SUP], Paolo Pelosi[SUP] 2 3 [/SUP], Matteo Bassetti[SUP] 1 7 [/SUP]
Affiliations
- PMID: 33546093
- DOI: 10.3390/jcm10040555
Abstract
The primary objective of this multicenter, observational, retrospective study was to assess the incidence rate of ventilator-associated pneumonia (VAP) in coronavirus disease 2019 (COVID-19) patients in intensive care units (ICU). The secondary objective was to assess predictors of 30-day case-fatality of VAP. From 15 February to 15 May 2020, 586 COVID-19 patients were admitted to the participating ICU. Of them, 171 developed VAP (29%) and were included in the study. The incidence rate of VAP was of 18 events per 1000 ventilator days (95% confidence intervals [CI] 16-21). Deep respiratory cultures were available and positive in 77/171 patients (45%). The most frequent organisms were Pseudomonas aeruginosa (27/77, 35%) and Staphylococcus aureus (18/77, 23%). The 30-day case-fatality of VAP was 46% (78/171). In multivariable analysis, septic shock at VAP onset (odds ratio [OR] 3.30, 95% CI 1.43-7.61, p = 0.005) and acute respiratory distress syndrome at VAP onset (OR 13.21, 95% CI 3.05-57.26, p < 0.001) were associated with fatality. In conclusion, VAP is frequent in critically ill COVID-19 patients. The related high fatality is likely the sum of the unfavorable prognostic impacts of the underlying viral and the superimposed bacterial diseases.
Keywords: COVID-19; SARS-CoV-2; VAP; coronavirus; ventilation.