Your browser doesn't support javascript.
Relationship between ventilator-associated pneumonia and mortality in COVID-19 patients: a planned ancillary analysis of the coVAPid cohort.
Nseir, Saad; Martin-Loeches, Ignacio; Povoa, Pedro; Metzelard, Matthieu; Du Cheyron, Damien; Lambiotte, Fabien; Tamion, Fabienne; Labruyere, Marie; Makris, Demosthenes; Boulle Geronimi, Claire; Pinetonde Chambrun, Marc; Nyunga, Martine; Pouly, Olivier; Mégarbane, Bruno; Saade, Anastasia; Gomà, Gemma; Magira, Eleni; Llitjos, Jean-François; Torres, Antoni; Ioannidou, Iliana; Pierre, Alexandre; Coelho, Luis; Reignier, Jean; Garot, Denis; Kreitmann, Louis; Baudel, Jean-Luc; Voiriot, Guillaume; Contou, Damien; Beurton, Alexandra; Asfar, Pierre; Boyer, Alexandre; Thille, Arnaud W; Mekontso-Dessap, Armand; Tsolaki, Vassiliki; Vinsonneau, Christophe; Floch, Pierre-Edouard; Le Guennec, Loïc; Ceccato, Adrian; Artigas, Antonio; Bouchereau, Mathilde; Labreuche, Julien; Duhamel, Alain; Rouzé, Anahita.
  • Nseir S; Médecine Intensive-Réanimation, CHU de Lille, F-59000, Lille, France. s-nseir@chru-lille.fr.
  • Martin-Loeches I; Inserm U1285, CNRS, UMR 8576-UGSF-Unité de Glycobiologie Structurale et Fonctionnelle, Univ. Lille, Lille, France. s-nseir@chru-lille.fr.
  • Povoa P; Department of Intensive Care Medicine, Multidisciplinary Intensive Care Research Organization (MICRO), St. James's Hospital, St. James Street, Dublin 8, Dublin, Eire, Ireland.
  • Metzelard M; Hospital Clinic, IDIBAPS, Universided de Barcelona, CIBERes, Barcelona, Spain.
  • Du Cheyron D; Polyvalent Intensive Care Unit, São Francisco Xavier Hospital, Centro Hospitalar de Lisboa Ocidental, and NOVA Medical School, CHRC, New University of Lisbon, Lisbon, Portugal.
  • Lambiotte F; Center for Clinical Epidemiology and Research Unit of Clinical Epidemiology, OUH Odense University Hospital, Odense, Denmark.
  • Tamion F; Medical ICU, Amiens University Hospital, Amiens, France.
  • Labruyere M; Department of Medical Intensive Care, Caen University Hospital, 14000, Caen, France.
  • Makris D; Service de Réanimation Polyvalente, Centre Hospitalier de Valenciennes, Valenciennes, France.
  • Boulle Geronimi C; Medical Intensive Care Unit, Rouen University Hospital, Normandie Université, UNIROUEN, Inserm U1096, FHU-REMOD-VHF, 76000, Rouen, France.
  • Pinetonde Chambrun M; Department of Intensive Care, François Mitterrand University Hospital, Dijon, France.
  • Nyunga M; Intensive Care Unit, University Hospital of Larissa, University of Thessaly, 41110, Biopolis Larissa, Greece.
  • Pouly O; Service de Réanimation Et de Soins Intensifs, Centre Hospitalier de Douai, Route de Cambrai, Douai, France.
  • Mégarbane B; Service de Médecine Intensive Réanimation, Institut de Cardiologie, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (APHP), Sorbonne Université, 47-83, Boulevard de L'Hôpital, 75651, Paris Cedex 13, France.
  • Saade A; ICU, Roubaix Hospital, Roubaix, France.
  • Gomà G; Médecine Intensive Réanimation, Hôpital Saint Philibert GHICL, Université Catholique, Lille, France.
  • Magira E; Réanimation Médicale Et Toxicologique, Hôpital Lariboisière, Université de Paris, INSERM UMRS-1144, Paris, France.
  • Llitjos JF; Service de Médecine Intensive Et Réanimation, Hôpital Saint-Louis, 1 Avenue Claude Vellefaux, 75010, Paris, France.
  • Torres A; Critical Care Department, Hospital Universitari Parc Taulí, Sabadell, Spain.
  • Ioannidou I; 1St Department of Intensive Care Medicine, National and Kapodistrian University of Athens Medical School, Evaggelismos Hospital, Athens, Greece.
  • Pierre A; Medical Intensive Care Unit, Cochin Hospital, AP-HP. Centre, Université de Paris, Paris, France.
  • Coelho L; Department of Pulmonology, Hospital Clinic Barcelona, University of Barcelona, IDIBAPS, CIBERES, ICREA, Barcelona, Spain.
  • Reignier J; 1St Department of Pulmonary Medicine and Intensive Care Unit, National and Kapodistrian University of Athens, "Sotiria" Chest Hospital, Athens, Greece.
  • Garot D; Réanimation Polyvalente, CH Lens, Lens, France.
  • Kreitmann L; Polyvalent Intensive Care Unit, São Francisco Xavier Hospital, Centro Hospitalar de Lisboa Ocidental, and NOVA Medical School, CHRC, New University of Lisbon, Lisbon, Portugal.
  • Baudel JL; Service de Médecine Intensive Réanimation, CHU de Nantes, Nantes, France.
  • Voiriot G; Service de Médecine Intensive Réanimation, CHU de Tours, Hôpital Bretonneau, 2 Bd Tonnellé, 37000, Tours, France.
  • Contou D; Service de Médecine Intensive - Réanimation, Hospices Civils de Lyon, Hôpital Edouard Herriot, 5, place d'Arsonval, 69437, Lyon Cedex 03, France.
  • Beurton A; Service de Médecine Intensive Réanimation, AP-HP, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, 184 rue du Faubourg Saint-Antoine, 75571, Paris Cedex 12, France.
  • Asfar P; Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Service de Médecine Intensive Réanimation, Hôpital Tenon, Paris, France.
  • Boyer A; Réanimation Polyvalente, CH Victor Dupouy, Argenteuil, France.
  • Thille AW; Service de Pneumologie, Médecine Intensive - Réanimation (Département "R3S"), AP-HP, Sorbonne Université, Groupe Hospitalier Universitaire Pitié-Salpêtrière Charles Foix, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale Et Clinique, Paris, France.
  • Mekontso-Dessap A; Département de Médecine Intensive-Réanimation, CHU D'Angers, Université D'Angers, 4 rue Larrey, 49933, Angers Cedex 9, France.
  • Tsolaki V; Intensive Care Unit, Pellegrin-Tripode Hospital, University Hospital of Bordeaux, Bordeaux, France.
  • Vinsonneau C; CHU de Poitiers, Médecine Intensive Réanimation, CIC 1402 ALIVE, Université de Poitiers, Poitiers, France.
  • Floch PE; APHP, CHU Henri Mondor, Service de Médecine Intensive RéanimationUniversité Paris Est-Créteil, Faculté de Santé, Groupe de Recherche Clinique CARMASINSERM U955, Institut Mondor de Recherche Biomédicale, 94010, Créteil, France.
  • Le Guennec L; Intensive Care Unit, University Hospital of Larissa, University of Thessaly, 41110, Biopolis Larissa, Greece.
  • Ceccato A; Service de Médecine Intensive Réanimation, Centre Hospitalier de Béthune, Réseau de Recherche Boréal, 62408, Béthune, France.
  • Artigas A; Service de Réanimation, Hôpital Duchenne, Rue Monod, 62200, Boulogne-sur-Mer, France.
  • Bouchereau M; Sorbonne Université, AP-HP, Hôpital de La Pitié-Salpêtrière, Département de Neurologie, Unité de Médecine Intensive Réanimation Neurologique, Paris, France.
  • Labreuche J; Intensive Care Unit, Hospital Universitari Sagrat Cor, and Ciber de Enfermedades Respiratorias (Ciberes, CB06/06/0028)-Institut D'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain.
  • Duhamel A; Critical Care Center, Corporacion Sanitaria Universitaria Parc Tauli, CIBER Enfermedades Respiratorias, Autonomous University of Barcelona, Parc Tauli 1, 08028, Sabadell, Spain.
  • Rouzé A; Médecine Intensive-Réanimation, CHU de Lille, F-59000, Lille, France.
Crit Care ; 25(1): 177, 2021 05 25.
Article in English | MEDLINE | ID: covidwho-1352667
Semantic information from SemMedBD (by NLM)
1. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
2. Pneumoni PROCESS_OF C0030705
Subject
Pneumoni
Predicate
PROCESS_OF
Object
C0030705
3. 2019 novel coronavirus PROCESS_OF Patients
Subject
2019 novel coronavirus
Predicate
PROCESS_OF
Object
Patients
4. Pneumoni COEXISTS_WITH C5203676
Subject
Pneumoni
Predicate
COEXISTS_WITH
Object
C5203676
5. Pneumoni NEG_COEXISTS_WITH C0021400
Subject
Pneumoni
Predicate
NEG_COEXISTS_WITH
Object
C0021400
6. Pneumoni NEG_COEXISTS_WITH C0042769
Subject
Pneumoni
Predicate
NEG_COEXISTS_WITH
Object
C0042769
7. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
8. Pneumonia, Ventilator-Associated PROCESS_OF Patients
Subject
Pneumonia, Ventilator-Associated
Predicate
PROCESS_OF
Object
Patients
9. 2019 novel coronavirus PROCESS_OF Patients
Subject
2019 novel coronavirus
Predicate
PROCESS_OF
Object
Patients
10. Pneumonia, Ventilator-Associated COEXISTS_WITH 2019 novel coronavirus
Subject
Pneumonia, Ventilator-Associated
Predicate
COEXISTS_WITH
Object
2019 novel coronavirus
11. Pneumonia, Ventilator-Associated NEG_COEXISTS_WITH Influenza
Subject
Pneumonia, Ventilator-Associated
Predicate
NEG_COEXISTS_WITH
Object
Influenza
12. Pneumonia, Ventilator-Associated NEG_COEXISTS_WITH Virus Diseases
Subject
Pneumonia, Ventilator-Associated
Predicate
NEG_COEXISTS_WITH
Object
Virus Diseases
ABSTRACT

BACKGROUND:

Patients with SARS-CoV-2 infection are at higher risk for ventilator-associated pneumonia (VAP). No study has evaluated the relationship between VAP and mortality in this population, or compared this relationship between SARS-CoV-2 patients and other populations. The main objective of our study was to determine the relationship between VAP and mortality in SARS-CoV-2 patients.

METHODS:

Planned ancillary analysis of a multicenter retrospective European cohort. VAP was diagnosed using clinical, radiological and quantitative microbiological criteria. Univariable and multivariable marginal Cox's regression models, with cause-specific hazard for duration of mechanical ventilation and ICU stay, were used to compare outcomes between study groups. Extubation, and ICU discharge alive were considered as events of interest, and mortality as competing event.

FINDINGS:

Of 1576 included patients, 568 were SARS-CoV-2 pneumonia, 482 influenza pneumonia, and 526 no evidence of viral infection at ICU admission. VAP was associated with significantly higher risk for 28-day mortality in SARS-CoV-2 (adjusted HR 1.70 (95% CI 1.16-2.47), p = 0.006), and influenza groups (1.75 (1.03-3.02), p = 0.045), but not in the no viral infection group (1.07 (0.64-1.78), p = 0.79). VAP was associated with significantly longer duration of mechanical ventilation in the SARS-CoV-2 group, but not in the influenza or no viral infection groups. VAP was associated with significantly longer duration of ICU stay in the 3 study groups. No significant difference was found in heterogeneity of outcomes related to VAP between the 3 groups, suggesting that the impact of VAP on mortality was not different between study groups.

INTERPRETATION:

VAP was associated with significantly increased 28-day mortality rate in SARS-CoV-2 patients. However, SARS-CoV-2 pneumonia, as compared to influenza pneumonia or no viral infection, did not significantly modify the relationship between VAP and 28-day mortality. CLINICAL TRIAL REGISTRATION The study was registered at ClinicalTrials.gov, number NCT04359693.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Ventilator-Associated / COVID-19 Type of study: Controlled clinical trial / Observational study / Prognostic study / Randomized controlled trials / Risk factors Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Crit Care Year: 2021 Document Type: Article Affiliation country: S13054-021-03588-4

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Ventilator-Associated / COVID-19 Type of study: Controlled clinical trial / Observational study / Prognostic study / Randomized controlled trials / Risk factors Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Crit Care Year: 2021 Document Type: Article Affiliation country: S13054-021-03588-4