Sars-CoV-2 in critical immunocompromised patients. Evolution and prognosis
Critical Care Conference: 42nd International Symposium on Intensive Care and Emergency Medicine Brussels Belgium
; 27(Supplement 1), 2023.
Article
in English
| EMBASE | ID: covidwho-2318615
ABSTRACT
Introduction:
In this study, we share the results of immunosuppressed patients who suffered from acute respiratory distress syndrome (ARDS) secondary to COVID-19 pneumonia managed in our ICU. Method(s) We tracked all patients admitted to ICU of a Tertiary Hospital diagnosed with severe SARS-COV2 pneumonia from March 1, 2020 to January 31, 2022. The definition of Immunocompromised patient is based on history of transplantation, active neoplasia, autoimmune diseases or HIV. Collected data includes sex, age, type of immunosuppression, vaccination, mechanical ventilation, ECMO VV, incidence of superinfections and mortality. Result(s) From a cohort of 425 patients, 55 met the inclusion criteria. 33% were women and 67% male. The average age was 58 years for women and 62 years for men. Out of these patients, 27% had solid organ transplants. 40% suffered from neoplasic disease. 27% had autoimmune diseases and were under treatment with immunosuppressants. 3 had HIV. Only the 29% had received at least 1 dose of COVID 19 vaccine. 80% required orotracheal intubation. 3.64% (2) required Veno-Venous ECMO. 61% presented bacterial superinfection, with the most frequent germs being Pseudomonas aeruginosa and Enterococcus. 36% had viral superinfection, being cytomegalovirus the most frequent one. 32% had fungal superinfection, mainly by Aspergillus fumigatus. 27% did not suffer any superinfection. 40% of the total sample died. After logistic regression, in our model (AUC 83,4% (Se 57.1%, Sp 87.9%), we identified need of intubation as independent variable of mortality (OR 27,06 IC95% 1.76-415.55, p = 0.018). Conclusion(s) Immunocompromised patients with ARDS secondary to COVID-19 pneumonia present high mortality, with statistically significant difference when mechanical ventilation is needed. The most frequently isolated germs causing superinfection in this group of patients are bacterias. We believe that this group of patients require special care in our ICU units and an in-depth analysis and study to optimize their prognosis.
adult; adult respiratory distress syndrome; animal experiment; animal model; animal tissue; artificial ventilation; Aspergillus fumigatus; autoimmune disease; bacterial superinfection; cohort analysis; conference abstract; controlled study; coronavirus disease 2019; Cytomegalovirus; drug therapy; endotracheal intubation; Enterococcus; female; human; Human immunodeficiency virus infection; ic95; immunocompromised patient; immunosuppressive treatment; incidence; independent variable; male; mortality; neoplasm; nonhuman; patient history of transplantation; prognosis; Pseudomonas aeruginosa; Severe acute respiratory syndrome coronavirus 2; surgery; tertiary care center; vaccination; veno-venous ECMO; immunosuppressive agent; SARS-CoV-2 vaccine
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Type of study:
Prognostic study
Language:
English
Journal:
Critical Care Conference: 42nd International Symposium on Intensive Care and Emergency Medicine Brussels Belgium
Year:
2023
Document Type:
Article
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