Bacterial Pneumonia in COVID-19 Critically Ill Patients: A Case Series

Dudoignon, Emmanuel; Caméléna, François; Deniau, Benjamin; Habay, Adrien; Coutrot, Maxime; Ressaire, Quentin; Plaud, Benoît; Berçot, Béatrice; Dépret, François

doi:10.1093/cid/ciaa762

Cited by 88 publications

(73 citation statements)

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“…This is now in accordance with more recent literature and updated guidelines for the treatment of COVID-19 [5,14,22]. Our data show a high incidence of VAP, with a strong predominance of gram negative bacteria, this is in accordance with previous reports of ICU patients with COVID-19 [15].…”

Section: Discussionsupporting

confidence: 93%

“…We observed a higher incidence of nosocomial infections compared to those reported in some recent meta-analysis [5,6,12]. However, when we compared our results with those of studies that only included COVID-19 patients hospitalized in the ICU, we observed more similar results [11,[13][14][15][16]. The occurrence of a nosocomial infection was a late complication, occurring after a median of more than one week of ICU stay.…”

Section: Discussionsupporting

confidence: 71%

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Nosocomial infections associated to COVID-19 in the Intensive Care Unit. Clinical characteristics and outcome

Bardi

Pintado

Gómez-Rojo

et al. 2020

Preprint

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Background: Bacterial and fungal co-infection has been reported in patients with COVID-19, but there is limited experience on these infections in critically ill patients.Aim: To assess the characteristics and outcome of ICU-acquired infections in COVID-19 patients.Methods: In this retrospective single-centre, case-control study, we included 140 patients with severe COVID-19 admitted to the ICU between March and May 2020. We evaluated the epidemiological, clinical and microbiological features, and outcome of ICU-acquired infections.Results: Fifty seven patients (40.7%), developed a bacterial or fungal nosocomial infection during ICU stay. Infection occurred after a median of 9 days (IQR 5-11) of admission, and was significantly associated with the APACHE II score (p=0.02). There were 91 episodes of infection: primary (31%) and catheter-related (25%) bloodstream infections were the most frequent, followed by pneumonia (23%), tracheobronchitis (10%) and urinary tract infection (8%), that were produced by a wide spectrum of Gram positive (55%) and Gram negative bacteria (30%) as well as fungi (15%). In 60% of cases, infection was associated with septic shock, and a significant increase in SOFA score. Overall ICU mortality was 36% (51/140). Infection was significantly associated with death (OR 2.7, 95% CI 1.2-5.9, p=0.015), and a longer ICU stay (p<0.001).Conclusions: Bacterial and fungal nosocomial infection is a common complication of ICU admission in patients with COVID-19. It usually presents as a severe form of infection and it is associated with a high mortality and longer course of ICU stay.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 71%

Nosocomial infections associated to COVID-19 in the Intensive Care Unit. Clinical characteristics and outcome

Bardi

Pintado

Gómez-Rojo

et al. 2020

Preprint

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“…In a recent study involving 21 mixed ICU and non-ICU COVID-19 patients, LDL-C concentrations were significantly decreased upon admission and were inversely correlated with disease severity [ 30 ]. Most patients with COVID-19 in the ICU develop bacterial ventilator-associated pneumonia (VAP) [ 31 ], suggesting that both COVID-19 and bacterial infection may influence the lipid profile.…”

Section: Introductionmentioning

confidence: 99%

Lipoprotein concentrations over time in the intensive care unit COVID-19 patients: Results from the ApoCOVID study

et al. 2020

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Introduction Severe acute respiratory syndrome coronavirus2 has caused a global pandemic of coronavirus disease 2019 (COVID-19). High-density lipoproteins (HDLs), particles chiefly known for their reverse cholesterol transport function, also display pleiotropic properties, including anti-inflammatory or antioxidant functions. HDLs and low-density lipoproteins (LDLs) can neutralize lipopolysaccharides and increase bacterial clearance. HDL cholesterol (HDL-C) and LDL cholesterol (LDL-C) decrease during bacterial sepsis, and an association has been reported between low lipoprotein levels and poor patient outcomes. The goal of this study was to characterize the lipoprotein profiles of severe ICU patients hospitalized for COVID-19 pneumonia and to assess their changes during bacterial ventilator-associated pneumonia (VAP) superinfection. Methods A prospective study was conducted in a university hospital ICU. All consecutive patients admitted for COVID-19 pneumonia were included. Lipoprotein levels were assessed at admission and daily thereafter. The assessed outcomes were survival at 28 days and the incidence of VAP.

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“…Similarly, for hospital-acquired infections in COVID-19 patients, a recurring observation is the predominance of bacterial and fungal infections occurring in critical care [ 13 ]. Ventilator-associated pneumonia appears to be a predominant hospital-acquired infection reported in the literature [ 4 , 13 ]. Invasive fungal infection has also been highlighted as a concern in critically unwell patients with COVID-19 [ 14 ].…”

mentioning

confidence: 99%