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Incidence and Prognosis of Ventilator-Associated Pneumonia in Critically Ill Patients with COVID-19: A Multicenter Study

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Infectious Diseases Unit, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
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Anaesthesia and Intensive Care, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
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Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, 16132 Genoa, Italy
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Infectious Diseases Unit, Department of Medical and Surgical Sciences, Policlinico Sant’Orsola, 40138 Bologna, Italy
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Department of Anesthesia and Intensive Care, University Hospital of Modena, 41124 Modena, Italy
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Clinical Department of Medical, Surgical and Health Science, Trieste University, 34127 Trieste, Italy
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Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy
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Emergenza Infettivologica PS, Cotugno Hospital, AORN dei Colli, 80131 Naples, Italy
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First Division of Infectious Diseases, Cotugno Hospital, AORN dei Colli, 80131 Naples, Italy
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Department of Surgical Sciences, University of Turin, 10126 Turin, Italy
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Unit of Anesthesia and Resuscitation 1, Department of Anesthesia, Intensive Care, and Emergency, Città della Salute e della Scienza, 10126 Turin, Italy
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Infectious Diseases Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliera Universitaria Pisana, University of Pisa, 56126 Pisa, Italy
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Intensive Care Unit, Cotugno Hospital, AORN dei Colli, 80131 Naples, Italy
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Department of Anesthesia and Intensive Care Medicine; Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI), 34148 Trieste, Italy
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SubIntensiva Covid, Cotugno Hospital, AORN dei Colli, 80131 Naples, Italy
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Dipartimento Area Critica, AORN dei Colli, 80131 Naples, Italy
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Department of Medical Sciences, Infectious Diseases, University of Turin, 10126 Turin, Italy
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Intensive Care Unit, Department of Medical and Surgical Sciences, Policlinico Sant’Orsola, 40138 Bologna, Italy
*
Author to whom correspondence should be addressed.
Academic Editor: Erlangga Yusuf
J. Clin. Med. 2021, 10(4), 555; https://doi.org/10.3390/jcm10040555
Received: 4 January 2021 / Revised: 21 January 2021 / Accepted: 22 January 2021 / Published: 3 February 2021
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. View Full-Text
Keywords: VAP; COVID-19; SARS-CoV-2; coronavirus; ventilation VAP; COVID-19; SARS-CoV-2; coronavirus; ventilation
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MDPI and ACS Style

Giacobbe, D.R.; Battaglini, D.; Enrile, E.M.; Dentone, C.; Vena, A.; Robba, C.; Ball, L.; Bartoletti, M.; Coloretti, I.; Di Bella, S.; Di Biagio, A.; Brunetti, I.; Mikulska, M.; Carannante, N.; De Maria, A.; Magnasco, L.; Maraolo, A.E.; Mirabella, M.; Montrucchio, G.; Patroniti, N.; Taramasso, L.; Tiseo, G.; Fornaro, G.; Fraganza, F.; Monastra, L.; Roman-Pognuz, E.; Paluzzano, G.; Fiorentino, G.; Corcione, A.; Bussini, L.; Pascale, R.; Corcione, S.; Tonetti, T.; Rinaldi, M.; Falcone, M.; Biagioni, E.; Ranieri, V.M.; Giannella, M.; De Rosa, F.G.; Girardis, M.; Menichetti, F.; Viale, P.; Pelosi, P.; Bassetti, M. Incidence and Prognosis of Ventilator-Associated Pneumonia in Critically Ill Patients with COVID-19: A Multicenter Study. J. Clin. Med. 2021, 10, 555. https://doi.org/10.3390/jcm10040555

AMA Style

Giacobbe DR, Battaglini D, Enrile EM, Dentone C, Vena A, Robba C, Ball L, Bartoletti M, Coloretti I, Di Bella S, Di Biagio A, Brunetti I, Mikulska M, Carannante N, De Maria A, Magnasco L, Maraolo AE, Mirabella M, Montrucchio G, Patroniti N, Taramasso L, Tiseo G, Fornaro G, Fraganza F, Monastra L, Roman-Pognuz E, Paluzzano G, Fiorentino G, Corcione A, Bussini L, Pascale R, Corcione S, Tonetti T, Rinaldi M, Falcone M, Biagioni E, Ranieri VM, Giannella M, De Rosa FG, Girardis M, Menichetti F, Viale P, Pelosi P, Bassetti M. Incidence and Prognosis of Ventilator-Associated Pneumonia in Critically Ill Patients with COVID-19: A Multicenter Study. Journal of Clinical Medicine. 2021; 10(4):555. https://doi.org/10.3390/jcm10040555

Chicago/Turabian Style

Giacobbe, Daniele R., Denise Battaglini, Elisa M. Enrile, Chiara Dentone, Antonio Vena, Chiara Robba, Lorenzo Ball, Michele Bartoletti, Irene Coloretti, Stefano Di Bella, Antonio Di Biagio, Iole Brunetti, Malgorzata Mikulska, Novella Carannante, Andrea De Maria, Laura Magnasco, Alberto E. Maraolo, Michele Mirabella, Giorgia Montrucchio, Nicolò Patroniti, Lucia Taramasso, Giusy Tiseo, Giacomo Fornaro, Fiorentino Fraganza, Luca Monastra, Erik Roman-Pognuz, Giacomo Paluzzano, Giuseppe Fiorentino, Antonio Corcione, Linda Bussini, Renato Pascale, Silvia Corcione, Tommaso Tonetti, Matteo Rinaldi, Marco Falcone, Emanuela Biagioni, Vito M. Ranieri, Maddalena Giannella, Francesco G. De Rosa, Massimo Girardis, Francesco Menichetti, Pierluigi Viale, Paolo Pelosi, and Matteo Bassetti. 2021. "Incidence and Prognosis of Ventilator-Associated Pneumonia in Critically Ill Patients with COVID-19: A Multicenter Study" Journal of Clinical Medicine 10, no. 4: 555. https://doi.org/10.3390/jcm10040555

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