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Critical Care during COVID-19 Pandemic
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Critical Care during COVID-19 Pandemic

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Intensive Care".

Deadline for manuscript submissions: 20 August 2024 | Viewed by 2955

Special Issue Editor

Dr. Laurent Camous

E-Mail Website
Guest Editor
Intensive Care Unit, Guadeloupe Teaching Hospital, Antilles-Guyane University, Chemin de Chauvel, 97139 Les Abymes, France
Interests: intensive care medicine; mechanical ventilation; COVID-19; hemodialysis; critical care

Special Issue Information

Dear Colleagues,

The COVID-19 pandemic has been a key point of research for all physicians and in particular intensivists since early 2020. There has been huge scientific work undertaken in the fields of infectiology and intensive care to better understand the mechanisms of the disease and specific organ involvement as well as to improve patient care. The goal of this Special Issue is to update intensive care physicians on the procedures involved in COVID-19 patient management and provide a comprehensive collection of original articles and reviews on “critical care during the COVID-19 pandemic”.

To this end, we would like to invite you to submit state-of-the-art reviews on COVID-19 in the ICU, as well as original research in this area for publication in this issue.

The special edition will be divided into four sections:

  • The first one will focus on organ damage from SARS-COV2 infection, with reviews and original articles focusing on severe COVID-19 organ involvement.
  •  The second chapter will include articles on treatment of COVID-19 patients in intensive care and more specifically on respiratory support.
  • The third section will be dedicated to nosocomial infections associated with COVID-19 (for example, COVID-19-associated aspergillosis and super-infections in ICU COVID-19 patients), exhibiting a series and state-of-the art articles.
  • The last section will discuss what the pandemic has changed in the ICU for physicians and what has been learned from this historic period. The care of non-COVID-19 patients during surges will also be discussed.

This Special Issue aims to present the most recent advances in the field of severe COVID-19 patient management in intensive care units, as well as the lessons learned for future pandemics. We look forward greatly to your submissions.

Dr. Laurent Camous
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • acute respiratory distress syndrome
  • myocarditis
  • mechanical ventilation
  • ICU strain
  • viral infection
  • nosocomial infections

Published Papers (4 papers)

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Research

14 pages, 449 KiB  
Article
Pneumonia Characteristics in an Intensive Care Unit Setting during and after the COVID-19 Pandemic—A Single-Center Prospective Study
by Jakub Sleziak, Katarzyna Pilarczyk, Michal Matysiak and Wieslawa Duszynska
J. Clin. Med. 2024, 13(10), 2824; https://doi.org/10.3390/jcm13102824 - 10 May 2024
Viewed by 390
Abstract
Background: During and after the COVID-19 pandemic, there was a suspicion of varying rates of respiratory tract infections (RTIs), particularly pneumonia (PN). Methods: This research evaluated epidemiological indicators of community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP) in the COVID-19 pandemic and post-pandemic [...] Read more.
Background: During and after the COVID-19 pandemic, there was a suspicion of varying rates of respiratory tract infections (RTIs), particularly pneumonia (PN). Methods: This research evaluated epidemiological indicators of community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP) in the COVID-19 pandemic and post-pandemic period, including pathogens, ventilator-associated pneumonia (VAP), selected risk factors, and PN mortality. Results: At 1740 patients, throughout the 22,774 patient-days (Pt-D) and 18,039 ventilation days (Vt-D), there were 681 PN cases (39.14%): CAP 336 (19.31%) and HAP 345 (19.83%). CAP caused by SARS-CoV-2 was diagnosed in 257/336 (76.49%) patients. The clinical manifestations of PNs were CAP with 336/681 (49.34%), VAP with 232/681 (34.07%), and non-ventilator HAP (NV-HAP) with 113/681 cases (16.59%). The incidence rate of CAP/1000 Pt-D has been over 3 times higher in the pandemic period of 2020–2021 (20.25) than in the post-pandemic period of 2022 (5.86), p = 0.000. Similarly, higher incidence rates of VAP/1000 Pt-D were found in the pandemic period (p = 0.050). For NV-HAP, this difference was not statistically significant (p = 0.585). VAP occurred more frequently in the group of patients with PN in the course of COVID-19 compared to patients without COVID-19 (52/234 [22.2%] vs. 180/1506 [11.95%]); (p = 0.000). The most common CAP pathogen (during the pandemic) was SARS CoV-2 234/291 (80.4%), followed by MSSA/MRSA 8/291 (2.75%), whereas the most common VAP/NV-HAP pathogen was Acinetobacter baumannii XDR/MDR. The highest PN mortality was found in the patients with CAP caused by SARS-CoV-2 159/257 (61.87%). Conclusions: Pneumonias were diagnosed in nearly 40% of Intensive Care Unit (ICU) patients. Surveillance of pneumonias during the specific observation period was beneficial in the epidemiological and microbiological analysis of the ICU patients. Full article
(This article belongs to the Special Issue Critical Care during COVID-19 Pandemic)
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10 pages, 248 KiB  
Article
Nursing Practice of Airway Care Interventions and Prone Positioning in ICU Patients with COVID-19—A Dutch National Survey
by Andrea A. Esmeijer, Fleur van der Ven, Eveline Koornstra, Laurien Kuipers, Paula van Oosten, Pien Swart, Christel M. Valk, Marcus J. Schultz, Frederique Paulus and Willemke Stilma
J. Clin. Med. 2024, 13(7), 1983; https://doi.org/10.3390/jcm13071983 - 29 Mar 2024
Viewed by 673
Abstract
Background: Airway care interventions and prone positioning are used in critically ill patients with coronavirus disease 2019 (COVID-19) admitted to the intensive care unit (ICU) to improve oxygenation and facilitate mucus removal. At the onset of the COVID-19 pandemic, the decision-making process [...] Read more.
Background: Airway care interventions and prone positioning are used in critically ill patients with coronavirus disease 2019 (COVID-19) admitted to the intensive care unit (ICU) to improve oxygenation and facilitate mucus removal. At the onset of the COVID-19 pandemic, the decision-making process regarding the practice of airway care interventions and prone positioning was challenging. Objective: To provide an overview of the practice of airway care interventions and prone positioning during the second wave of the pandemic in the Netherlands. Method: Web-based survey design. Seventy ICU nurses, each representing one intensive care in the Netherlands, were contacted for participation. Potential items were generated based on a literature search and formulated by a multidisciplinary team. Questions were pilot tested for face and construct validity by four intensive care nurses from four different hospitals. Results: The response rate was 53/77 (69%). This survey revealed widespread use of airway care interventions in the Netherlands in COVID-19 patients, despite questionable benefits. Additionally, prone positioning was used in invasively and non–invasively ventilated patients. Conclusions: The use of airway care interventions and prone positioning is time consuming and comes with the production of waste. Further research is needed to assess the effectiveness, workload, and environmental impact of airway care interventions and prone positioning. Full article
(This article belongs to the Special Issue Critical Care during COVID-19 Pandemic)
17 pages, 1489 KiB  
Article
Predictors of Mortality and Orotracheal Intubation in Patients with Pulmonary Barotrauma Due to COVID-19: An Italian Multicenter Observational Study during Two Years of the Pandemic
by Nardi Tetaj, Gennaro De Pascale, Massimo Antonelli, Joel Vargas, Martina Savino, Francesco Pugliese, Francesco Alessandri, Giovanni Giordano, Pierfrancesco Tozzi, Monica Rocco, Anna Maria Biava, Luigi Maggi, Raffaella Pisapia, Francesco Maria Fusco, Giulia Valeria Stazi, Gabriele Garotto, Maria Cristina Marini, Pierluca Piselli, Alessia Beccacece, Andrea Mariano, Maria Letizia Giancola, Stefania Ianniello, Francesco Vaia, Enrico Girardi, Andrea Antinori, Maria Grazia Bocci, Luisa Marchioni and Emanuele Nicastriadd Show full author list remove Hide full author list
J. Clin. Med. 2024, 13(6), 1707; https://doi.org/10.3390/jcm13061707 - 15 Mar 2024
Viewed by 778
Abstract
Introduction: Coronavirus disease 2019 (COVID-19) is a significant and novel cause of acute respiratory distress syndrome (ARDS). During the COVID-19 pandemic, there has been an increase in the incidence of cases involving pneumothorax and pneumomediastinum. However, the risk factors associated with poor outcomes [...] Read more.
Introduction: Coronavirus disease 2019 (COVID-19) is a significant and novel cause of acute respiratory distress syndrome (ARDS). During the COVID-19 pandemic, there has been an increase in the incidence of cases involving pneumothorax and pneumomediastinum. However, the risk factors associated with poor outcomes in these patients remain unclear. Methods: This observational study collected clinical and imaging data from COVID-19 patients with PTX and/or PNM across five tertiary hospitals in central Italy between 1 March 2020 and 1 March 2022. This study also calculated the incidence of PTX and PNM and utilized multivariable regression analysis and Kaplan–Meier curve analysis to identify predictor factors for 28-day mortality and 3-day orotracheal intubation after PTX/PNM. This study also considered the impact of the three main variants of concern (VoCs) (alfa, delta, and omicron) circulating during the study period. Results: During the study period, a total of 11,938 patients with COVID-19 were admitted. This study found several factors independently associated with a higher risk of death in COVID-19 patients within 28 days of pulmonary barotrauma. These factors included a SOFA score ≥ 4 (OR 3.22, p = 0.013), vasopressor/inotropic therapy (OR 11.8, p < 0.001), hypercapnia (OR 2.72, p = 0.021), PaO2/FiO2 ratio < 150 mmHg (OR 10.9, p < 0.001), and cardiovascular diseases (OR 7.9, p < 0.001). This study also found that a SOFA score ≥ 4 (OR 3.10, p = 0.015), PCO2 > 45 mmHg (OR 6.0, p = 0.003), and P/F ratio < 150 mmHg (OR 2.9, p < 0.042) were factors independently associated with a higher risk of orotracheal intubation (OTI) within 3 days from PTX/PNM in patients with non-invasive mechanical ventilation. SARS-CoV-2 VoCs were not associated with 28-day mortality or the risk of OTI. The estimated cumulative probability of OTI in patients after pneumothorax was 44.0% on the first day, 67.8% on the second day, and 68.9% on the third day, according to univariable survival analysis. In patients who had pneumomediastinum only, the estimated cumulative probability of OTI was 37.5%, 46.7%, and 57.7% on the first, second, and third days, respectively. The overall incidence of PTX/PNM among hospitalized COVID-19 patients was 1.42%, which increased up to 4.1% in patients receiving invasive mechanical ventilation. Conclusions: This study suggests that a high SOFA score (≥4), the need for vasopressor/inotropic therapy, hypercapnia, and PaO2/FiO2 ratio < 150 mmHg in COVID-19 patients with pulmonary barotrauma are associated with higher rates of intubation, ICU admission, and mortality. Identifying these risk factors early on can help healthcare providers anticipate and manage these patients more effectively and provide timely interventions with appropriate intensive care, ultimately improving their outcomes. Full article
(This article belongs to the Special Issue Critical Care during COVID-19 Pandemic)
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13 pages, 602 KiB  
Article
Acute Kidney Injury and Chronic Kidney Disease and Their Impacts on Prognosis among Patients with Severe COVID-19 Pneumonia: An Expert Center Case–Cohort Study
by Jakub Klimkiewicz, Anna Grzywacz, Andrzej Michałowski, Mateusz Gutowski, Kamil Paryż, Ewelina Jędrych and Arkadiusz Lubas
J. Clin. Med. 2024, 13(5), 1486; https://doi.org/10.3390/jcm13051486 - 5 Mar 2024
Viewed by 746
Abstract
Background: Acute kidney injury (AKI) is associated with substantial mortality. In this case–control study, we analyzed the impacts of AKI and chronic kidney disease (CKD) on outcomes in a group of 323 patients with severe COVID-19. The correlation of clinical and laboratory [...] Read more.
Background: Acute kidney injury (AKI) is associated with substantial mortality. In this case–control study, we analyzed the impacts of AKI and chronic kidney disease (CKD) on outcomes in a group of 323 patients with severe COVID-19. The correlation of clinical and laboratory data with AKI and CKD was also analyzed. Methods: A retrospective case–control study was conducted among AKI, CKD, and normal kidney function (NKF) groups hospitalized in a COVID-19 center in 2021. Results: AKI patients had higher in-hospital mortality (55.2 vs. 18.8%, p < 0.001), more frequent transfers from the HDU to ICU (57.5 vs. 12.9%, p < 0.001), and prolonged hospital stays (15.4 ± 10.7 vs. 10.7 ± 6.7 days, p < 0.001) compared to the NKF group. AKI was a predictor of death (OR 4.794, 95%CI: 2.906–7.906, p < 0.001). AKI patients also had broader lung parenchymal involvement and higher inflammatory markers compared to the NKF group. Patients with prior CKD had higher in-hospital mortality compared to the NKF group (64.0 vs. 18.8%, p < 0.001, OR 4.044, 95%CI: 1.723–9.490, p = 0.013); however, transfers from the HDU to ICU were not more frequent (16.0 vs. 12.9%, p = 0.753). Conclusions: AKI among COVID-19 patients was correlated with more ICU transfers, higher morbidity, and greater markers of severe disease. Patients with CKD had a higher mortality; however, the rate of ICU transfer was not substantially higher due to their poor prognosis. Full article
(This article belongs to the Special Issue Critical Care during COVID-19 Pandemic)
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