RESUMO
Background: Patients with obstructive sleep apnea (OSA), related to their disease consequences and treatment modalities, are physically and mentally vulnerable during the outbreak. Objectives: To investigate the association between pandemic-related changes and positive airway pressure (PAP) adherence and sleep quality in OSA patients. Methods: This was a multi-center cross-sectional study, and the necessary data were collected prospectively. A total of 221 patients were included in the study, who were invited from four different centers from June 1 - December 1, 2020. Pittsburgh Sleep Quality Index (PSQI) was administered to evaluate sleep quality. Information on demographics positive airway pressure (PAP) device use, Coronavirus disease (COVID-19) a questionnaire collected related changes. Patients >18 years with a diagnosis of OSA and prescribed PAP treatment before the pandemic period were included in the study. Lack of cooperation with the questionnaires and incompliant with PAP treatment for longer than one year were the exclusion criteria. Results: Of the 221 participants, 79.2% were men. The mean apnea-hypopnea index was obtained at 40.8+or-24.3. A positive COVID-19 test was reported in nine cases, and three patients had hospitalization. During the pandemic, 102 (46.2%) subjects were retired, 26 (11.8%) lost their jobs, and 34 (15.3%) reported home office work or on-call or on leave. Poor sleep quality was found in 54 (24.4%) individuals. It was also reported that poor sleep quality was more common in those who reported mask use difficulty (38.7% vs. 18.9%;P=0.004) and increased or decreased PAP use (increased, decreased, no change in PAP use: 45.5%, 36.0%, 19.4%, respectively;P=0.01). The good sleep quality group had higher PAP use than the poor sleep quality group (6.2+or-1.5 vs. 5.3+or-2.4 night/week;P=0.002;6.2+or-1.5 vs. 5.5+or-2.2 hour/night;P=0.01). Conclusions: Pandemic period had several negative effects on sleep apnea patients regarding sleep quality and social lives which also influenced PAP adherence in OSA patients. Most patients did not change their regular PAP use attitudes during this period. Similar to the pre-COVID-19 disease period, PAP adherence and compliance positively influenced sleep quality;people who were "good sleepers" were the ones who were the "good PAP device users".
RESUMO
Background: Ventilator associated events (VAE) algorithm is increasingly used for the surveillance of ventilator associated problems as an alternative tool of traditional ventilator associated pneumonia (VAP) definition for surveillance. COVID-19's impact on reliability of VAE for VAP is poorly defined. Aims and objectives: To compare the performance of traditional VAP criteria with VAE criteria to detect ventilator associated problems in intensive care unit (ICU) patients with COVID-19 pneumonia. Method(s): Patients who were intubated for more than 48 hours in COVID-19 ICU were included. COVID-19 was diagnosed with polymerase chain reaction. For traditional VAP surveillance definition, CDC PNEU/VAP criteria were used. For VAE definition, CDC/NHSN VAE algorithm was used. Both VAE and PNEU/VAP surveillance were conducted manually by two investigators who were blind to each other. NHSN VAE calculator version 8.1 was used to verify VAE. Result(s): Seventy-seven patients met inclusion criteria during the 1-year study period. Mean (+/- SD) age was 68.7 (+/-13), 67.5% were male, median Charlson comorbidity index score was 4 (IQR 3). Thirty-three patients were diagnosed as PNEU/VAP. VAE were detected in fifteen patients. Eleven patients met both VAP and VAE criteria. The VAP rate was 13.55 per 1000 ventilator days, VAE rate was 6.16 per 1000 ventilator days. Conclusion(s): CDC PNEU/VAP criteria detected higher rate of ventilator associated problems when compared with VAE in patients with COVID-19.