Relationship between ventilator-associated pneumonia and mortality in COVID-19 patients: a planned ancillary analysis of the coVAPid cohort

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...

Full description

Bibliographic Details
Authors: Nseir, S, Martin-Loeches, I, Povoa, P, Metzelard, M, Du Cheyron, D, Lambiotte, F, Tamion, F, Labruyere, M, Makris, D, Geronimi, CB, Chambrun, MP, Nyunga, M, Pouly, O, Megarbane, B, Saade, A, Goma, G, Magira, E, Llitjos, JF, Torres, A, Ioannidou, I, Pierre, A, Coelho, L, Reignier, J, Garot, D, Kreitmann, L, Baudel, JL, Voiriot, G, Contou, D, Beurton, A, Asfar, P, Boyer, A, Thille, AW, Mekontso-Dessap, A, Tsolaki, V, Vinsonneau, C, Floch, PE, Le Guennec, L, Ceccato, A, Artigas, A, Bouchereau, M, Labreuche, J, Duhamel, A, Rouze, A
Format: article
Status:Published version
Publication Date:2021
Country:España
Institution:Institut d'Investigació i Innovació Parc Taulí (I3PT)
Repository:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
OAI Identifier:oai:i3pt.fundanetsuite.com:p2022
Online Access:https://i3pt.portalinvestigacion.com/publicaciones/2022
Access Level:Open access
Keyword:Ventilator-associated pneumonia
Mortality
COVID-19
id ES_f29a1efc3ff51435ccb055a5edcdc81e
oai_identifier_str oai:i3pt.fundanetsuite.com:p2022
network_acronym_str ES
network_name_str España
repository_id_str
spelling Relationship between ventilator-associated pneumonia and mortality in COVID-19 patients: a planned ancillary analysis of the coVAPid cohortNseir, SMartin-Loeches, IPovoa, PMetzelard, MDu Cheyron, DLambiotte, FTamion, FLabruyere, MMakris, DGeronimi, CBChambrun, MPNyunga, MPouly, OMegarbane, BSaade, AGoma, GMagira, ELlitjos, JFTorres, AIoannidou, IPierre, ACoelho, LReignier, JGarot, DKreitmann, LBaudel, JLVoiriot, GContou, DBeurton, AAsfar, PBoyer, AThille, AWMekontso-Dessap, ATsolaki, VVinsonneau, CFloch, PELe Guennec, LCeccato, AArtigas, ABouchereau, MLabreuche, JDuhamel, ARouze, AVentilator-associated pneumoniaMortalityCOVID-19Background 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.BMC2021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://i3pt.portalinvestigacion.com/publicaciones/2022CRITICAL CAREISSN: 13648535ISSNe: 1466609Xreponame:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulíinstname:Institut d'Investigació i Innovació Parc Taulí (I3PT)Inglésinfo:eu-repo/semantics/openAccessoai:i3pt.fundanetsuite.com:p20222026-06-21T15:30:37Z
dc.title.none.fl_str_mv Relationship between ventilator-associated pneumonia and mortality in COVID-19 patients: a planned ancillary analysis of the coVAPid cohort
title Relationship between ventilator-associated pneumonia and mortality in COVID-19 patients: a planned ancillary analysis of the coVAPid cohort
spellingShingle Relationship between ventilator-associated pneumonia and mortality in COVID-19 patients: a planned ancillary analysis of the coVAPid cohort
Nseir, S
Ventilator-associated pneumonia
Mortality
COVID-19
title_short Relationship between ventilator-associated pneumonia and mortality in COVID-19 patients: a planned ancillary analysis of the coVAPid cohort
title_full Relationship between ventilator-associated pneumonia and mortality in COVID-19 patients: a planned ancillary analysis of the coVAPid cohort
title_fullStr Relationship between ventilator-associated pneumonia and mortality in COVID-19 patients: a planned ancillary analysis of the coVAPid cohort
title_full_unstemmed Relationship between ventilator-associated pneumonia and mortality in COVID-19 patients: a planned ancillary analysis of the coVAPid cohort
title_sort Relationship between ventilator-associated pneumonia and mortality in COVID-19 patients: a planned ancillary analysis of the coVAPid cohort
dc.creator.none.fl_str_mv Nseir, S
Martin-Loeches, I
Povoa, P
Metzelard, M
Du Cheyron, D
Lambiotte, F
Tamion, F
Labruyere, M
Makris, D
Geronimi, CB
Chambrun, MP
Nyunga, M
Pouly, O
Megarbane, B
Saade, A
Goma, G
Magira, E
Llitjos, JF
Torres, A
Ioannidou, I
Pierre, A
Coelho, L
Reignier, J
Garot, D
Kreitmann, L
Baudel, JL
Voiriot, G
Contou, D
Beurton, A
Asfar, P
Boyer, A
Thille, AW
Mekontso-Dessap, A
Tsolaki, V
Vinsonneau, C
Floch, PE
Le Guennec, L
Ceccato, A
Artigas, A
Bouchereau, M
Labreuche, J
Duhamel, A
Rouze, A
author Nseir, S
author_facet Nseir, S
Martin-Loeches, I
Povoa, P
Metzelard, M
Du Cheyron, D
Lambiotte, F
Tamion, F
Labruyere, M
Makris, D
Geronimi, CB
Chambrun, MP
Nyunga, M
Pouly, O
Megarbane, B
Saade, A
Goma, G
Magira, E
Llitjos, JF
Torres, A
Ioannidou, I
Pierre, A
Coelho, L
Reignier, J
Garot, D
Kreitmann, L
Baudel, JL
Voiriot, G
Contou, D
Beurton, A
Asfar, P
Boyer, A
Thille, AW
Mekontso-Dessap, A
Tsolaki, V
Vinsonneau, C
Floch, PE
Le Guennec, L
Ceccato, A
Artigas, A
Bouchereau, M
Labreuche, J
Duhamel, A
Rouze, A
author_role author
author2 Martin-Loeches, I
Povoa, P
Metzelard, M
Du Cheyron, D
Lambiotte, F
Tamion, F
Labruyere, M
Makris, D
Geronimi, CB
Chambrun, MP
Nyunga, M
Pouly, O
Megarbane, B
Saade, A
Goma, G
Magira, E
Llitjos, JF
Torres, A
Ioannidou, I
Pierre, A
Coelho, L
Reignier, J
Garot, D
Kreitmann, L
Baudel, JL
Voiriot, G
Contou, D
Beurton, A
Asfar, P
Boyer, A
Thille, AW
Mekontso-Dessap, A
Tsolaki, V
Vinsonneau, C
Floch, PE
Le Guennec, L
Ceccato, A
Artigas, A
Bouchereau, M
Labreuche, J
Duhamel, A
Rouze, A
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Ventilator-associated pneumonia
Mortality
COVID-19
topic Ventilator-associated pneumonia
Mortality
COVID-19
description 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.
publishDate 2021
dc.date.none.fl_str_mv 2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://i3pt.portalinvestigacion.com/publicaciones/2022
url https://i3pt.portalinvestigacion.com/publicaciones/2022
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv BMC
publisher.none.fl_str_mv BMC
dc.source.none.fl_str_mv CRITICAL CARE
ISSN: 13648535
ISSNe: 1466609X
reponame:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
instname:Institut d'Investigació i Innovació Parc Taulí (I3PT)
instname_str Institut d'Investigació i Innovació Parc Taulí (I3PT)
reponame_str r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
collection r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869424296448753664
score 15,812429

Similar Items