Abstract
Introduction: Aim of this study is to analyse the characteristics of ventilator-associated pneumonia (VAP) inpatients infected by severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2). Materials and Methods: A retrospective study was conducted, including coronavirus infectious disease 2019 (COVID-19) patients who developed VAP from March to May 2020 (VAP COVID-19). They were compared to non-COVID-19 patients who developed VAP from January 2011 to December 2019 (VAP NO COVID-19) and COVID-19 patients who did not develop VAP (NO VAP COVID-19). Results: Overall, 42 patients were included in the VAP COVID-19group, 37 in the NO VAP COVID-19 group, and 188 in the VAP NO COVID-19 group. VAP COVID-19 had significantly higher rates of shock (71% vs. 48%, p = 0.009), death in ICU (52% vs. 30%, p = 0.011), VAP recurrence (28% vs. 4%, p < 0.0001), positive blood culture (26% vs. 13%, p = 0.038), and polymicrobial culture (28% vs. 13%, p = 0.011) than VAP NO COVID-19. At the multivariate analysis, death in patients with VAP was associated with shock (p = 0.032) and SARS-CoV-2 (p = 0.008) infection. Conclusions: VAP in COVID-19 patients is associated with shock, bloodstream, and polymicrobial infections.
Highlights
Aim of this study is to analyse the characteristics of ventilator-associated pneumonia (VAP) inpatients infected by severe acute respiratory syndrome-coronavirus 2 (SARS-CoV2)
COVID-19 patients experiencing VAP had significantly higher rates of shock (71% vs. 48%, p = 0.009), death in intensive care units (ICUs) (52% vs. 30%, p = 0.011), VAP recurrence (28% vs. 4%, p < 0.0001), clinical worsening at day 3 (81% vs. 32%, p < 0.0001) and 7 (83% vs. 28%, p < 0.0001), positive blood culture (26% vs. 13%, p = 0.038), and polymicrobial culture (28% vs. 13%, p = 0.011) than non-COVID-19 patients
This study showed that VAP was frequent in COVID-19 patients receiving mechanical ventilation, andit was associated with previous antibiotic treatment and shock.Its morbidity was principally due to SARS-CoV-2 infection and some other microbiologic characteristics, such as an association with positive blood cultures and polymicrobial cultures rather than patients’ related risk factors, such as immune-depression and co-morbidities.As expected, VAP in COVID-19 patients was associated with prolonged orotracheal intubation (OTI) and length of hospital stay
Summary
Aim of this study is to analyse the characteristics of ventilator-associated pneumonia (VAP) inpatients infected by severe acute respiratory syndrome-coronavirus 2 (SARS-CoV2). Materials and Methods: A retrospective study was conducted, including coronavirus infectious disease 2019 (COVID-19) patients who developed VAP from March to May 2020 (VAP COVID-19). They were compared to non-COVID-19 patients who developed VAP from January 2011 to December. Because the recurrence to mechanical ventilation is frequent, these patients are at risk of developing ventilator-associated pneumonia (VAP) [3]. VAP is a life-threatening disease associated with high mortality rates (43%) [5] It is sustained by different microorganisms, especially Staphylococcus aureus, Enterobacteriaceae, and non-fermenting Gramnegative bacteria (Pseudomonas aeruginosa, Acinetobacter baumannii, and Stenotrophomonas maltophilia) [4]. The main risk factors for VAP are: advanced age, male gender, increased duration of mechanical ventilation, prolonged length of hospital stay, multiple trauma, sep-
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