Relationship between ventilator-associated pneumonia and mortality in COVID-19 patients : a planned ancillary analysis of the coVAPid cohort
Nseir, Saad (Universitè de Lille)
Martin-Loeches, Ignacio (Hospital Clínic i Provincial de Barcelona)
Povoa, Pedro (Odense University Hospital (Dinamarca))
Metzelard, Matthieu (Amiens University Hospital)
Du Cheyron, Damien (Caen University Hospital (França))
Lambiotte, Fabien (Centre Hospitalier de Valenciennes)
Tamion, Fabienne (Rouen University Hospital (França))
Labruyere, Marie (François Mitterrand University Hospital)
Makris, Demosthenes (General University Hospital of Larissa (Grècia))
Boulle Geronimi, Claire (Centre Hospitalier de Douai)
Pinetonde Chambrun, Marc (Hôpital Pitié-Salpêtrière)
Nyunga, Martine (Roubaix Hospital (França))
Pouly, Olivier (Université Catholique (França))
Mégarbane, Bruno (Université de Paris)
Saade, Anastasia (Hôpital Saint-Louis (França))
Gomà, Gemma (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Magira, Eleni (National and Kapodistrian University of Athens Medical School)
Llitjos, Jean-François (Université de Paris)
Torres, Antoni (Hospital Clínic i Provincial de Barcelona)
Ioannidou, Iliana (National and Kapodistrian University of Athens)
Pierre, Alexandre (Réanimation Polyvalente (França))
Coelho, Luis (São Francisco Xavier Hospital)
Reignier, Jean (CHU de Nantes)
Garot, Denis (CHU de Tours)
Kreitmann, Louis (Hôpital Edouard Herriot)
Baudel, Jean-Luc (Assistance Publique-Hôpitaux de Paris)
Voiriot, Guillaume (Sorbonne Université)
Contou, Damien (CH Victor Dupouy)
Beurton, Alexandra (Sorbonne Université)
Asfar, Pierre (Université D'Angers)
Boyer, Alexandre (Bordeaux University Hospital (França))
Thille, Arnaud W. (Université de Poitiers)
Mekontso-Dessap, Armand (Université Paris Est-Créteil)
Tsolaki, Vassiliki (General University Hospital of Larissa (Grècia))
Vinsonneau, Christophe (Centre Hospitalier de Béthune, Réseau de Recherche Boréal. Service de Médecine Intensive Réanimation)
Floch, Pierre-Edouard (Service de Réanimation, Hôpital Duchenne, Rue Monod, 62200 Boulogne-sur-Mer, France)
Le Guennec, Loïc (Unité de Médecine Intensive Réanimation Neurologique. Sorbonne Université, AP-HP, Hôpital de La Pitié-Salpêtrière, Département de Neurologie)
Ceccato, Adrian (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Artigas Raventós, Antoni (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Bouchereau, Mathilde (CHU de Lille)
Labreuche, Julien (Université Lille)
Duhamel, Alain (Université Lille)
Rouzé, Anahita (Université Lille)
Universitat Autònoma de Barcelona

Data:	2021
Resum:	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. 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. 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. 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. The study was registered at ClinicalTrials. gov, number NCT04359693. The online version contains supplementary material available.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Ventilator-associated pneumonia ; Mortality ; COVID-19
Publicat a:	Critical Care, Vol. 25 (may 2021) , ISSN 1466-609X

DOI: 10.1186/s13054-021-03588-4
PMID: 34034777

11 p, 1.3 MB

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Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut d’Investigació i Innovació Parc Taulí (I3PT)
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