Incidence and prognosis of ventilator-associated pneumonia in critically ill patients with covid-19: A multicenter study

Daniele Roberto Giacobbe; Denise Battaglini; Elisa Martina Enrile; Chiara Dentone; Antonio Vena; Chiara Robba; Lorenzo Ball; Michele Bartoletti; Irene Coloretti; Stefano Di Bella; Antonio Di Biagio; Iole Brunetti; Malgorzata Mikulska; Novella Carannante; Andrea De Maria; Laura Magnasco; Alberto Enrico Maraolo; Michele Mirabella; Giorgia Montrucchio; Nicolò Patroniti; Lucia Taramasso; Giusy Tiseo; Giacomo Fornaro; Fiorentino Fraganza; Luca Monastra; Erik Roman-Pognuz; Giacomo Paluzzano; Giuseppe Fiorentino; Antonio Corcione; Linda Bussini; Renato Pascale; Silvia Corcione; Tommaso Tonetti; Matteo Rinaldi; Marco Falcone; Emanuela Biagioni; Vito Marco Ranieri; Maddalena Giannella; Francesco Giuseppe De Rosa; Massimo Girardis; Francesco Menichetti; Pierluigi Viale; Paolo Pelosi; Matteo Bassetti

doi:10.3390/jcm10040555

Incidence and prognosis of ventilator-associated pneumonia in critically ill patients with covid-19: A multicenter study

Daniele Roberto Giacobbe, Denise Battaglini, Elisa Martina Enrile, Chiara Dentone, Antonio Vena, Chiara Robba, Lorenzo Ball, Michele Bartoletti, Irene Coloretti, Stefano Di Bella, Antonio Di Biagio, Iole Brunetti, Malgorzata Mikulska, Novella Carannante, Andrea De Maria, Laura Magnasco, Alberto Enrico Maraolo, Michele Mirabella, Giorgia Montrucchio, Nicolò PatronitiLucia Taramasso, Giusy Tiseo, Giacomo Fornaro, Fiorentino Fraganza, Luca Monastra, Erik Roman-Pognuz, Giacomo Paluzzano, Giuseppe Fiorentino, Antonio Corcione, Linda Bussini, Renato Pascale, Silvia Corcione, Tommaso Tonetti, Matteo Rinaldi, Marco Falcone, Emanuela Biagioni, Vito Marco Ranieri, Maddalena Giannella, Francesco Giuseppe De Rosa, Massimo Girardis, Francesco Menichetti, Pierluigi Viale, Paolo Pelosi, Matteo Bassetti

Research output: Contribution to journal › Article › peer-review

Abstract

The primary objective of this multicenter, observational, retrospective study was to assess the incidence rate of ventilator-associated pneumonia (VAP) in coronavirus disease 2019 (COVID-19) patients in intensive care units (ICU). The secondary objective was to assess predictors of 30-day case-fatality of VAP. From 15 February to 15 May 2020, 586 COVID-19 patients were admitted to the participating ICU. Of them, 171 developed VAP (29%) and were included in the study. The incidence rate of VAP was of 18 events per 1000 ventilator days (95% confidence intervals [CI] 16–21). Deep respiratory cultures were available and positive in 77/171 patients (45%). The most frequent organisms were Pseudomonas aeruginosa (27/77, 35%) and Staphylococcus aureus (18/77, 23%). The 30-day case-fatality of VAP was 46% (78/171). In multivariable analysis, septic shock at VAP onset (odds ratio [OR] 3.30, 95% CI 1.43–7.61, p = 0.005) and acute respiratory distress syndrome at VAP onset (OR 13.21, 95% CI 3.05–57.26, p < 0.001) were associated with fatality. In conclusion, VAP is frequent in critically ill COVID-19 patients. The related high fatality is likely the sum of the unfavorable prognostic impacts of the underlying viral and the superimposed bacterial diseases.

Original language	English
Article number	555
Pages (from-to)	1-13
Number of pages	13
Journal	Journal of Clinical Medicine
Volume	10
Issue number	4
DOIs	https://doi.org/10.3390/jcm10040555
Publication status	Published - Feb 2 2021

Keywords

Coronavirus
COVID-19
SARS-CoV-2
VAP
Ventilation

ASJC Scopus subject areas

Medicine(all)

Access to Document

10.3390/jcm10040555

Cite this

Giacobbe, D. R., Battaglini, D., Enrile, E. M., Dentone, C., Vena, A., Robba, C., Ball, L., Bartoletti, M., Coloretti, I., Di Bella, S., Di Biagio, A., Brunetti, I., Mikulska, M., Carannante, N., De Maria, A., Magnasco, L., Maraolo, A. E., Mirabella, M., Montrucchio, G., ... Bassetti, M. (2021). Incidence and prognosis of ventilator-associated pneumonia in critically ill patients with covid-19: A multicenter study. Journal of Clinical Medicine, 10(4), 1-13. [555]. https://doi.org/10.3390/jcm10040555

Incidence and prognosis of ventilator-associated pneumonia in critically ill patients with covid-19: A multicenter study. / Giacobbe, Daniele Roberto; Battaglini, Denise; Enrile, Elisa Martina; Dentone, Chiara; Vena, Antonio; Robba, Chiara; Ball, Lorenzo; Bartoletti, Michele; Coloretti, Irene; Di Bella, Stefano; Di Biagio, Antonio ; Brunetti, Iole ; Mikulska, Malgorzata; Carannante, Novella; De Maria, Andrea; Magnasco, Laura; Maraolo, Alberto Enrico; Mirabella, Michele; Montrucchio, Giorgia; Patroniti, Nicolò ; Taramasso, Lucia; Tiseo, Giusy; Fornaro, Giacomo; Fraganza, Fiorentino; Monastra, Luca; Roman-Pognuz, Erik; Paluzzano, Giacomo; Fiorentino, Giuseppe; Corcione, Antonio; Bussini, Linda ; Pascale, Renato; Corcione, Silvia; Tonetti, Tommaso ; Rinaldi, Matteo ; Falcone, Marco; Biagioni, Emanuela; Ranieri, Vito Marco ; Giannella, Maddalena ; De Rosa, Francesco Giuseppe; Girardis, Massimo; Menichetti, Francesco; Viale, Pierluigi ; Pelosi, Paolo ; Bassetti, Matteo.

In: Journal of Clinical Medicine, Vol. 10, No. 4, 555, 02.02.2021, p. 1-13.

Research output: Contribution to journal › Article › peer-review

Giacobbe, DR, Battaglini, D, Enrile, EM, Dentone, C, Vena, A, Robba, C, Ball, L, Bartoletti, M, Coloretti, I, Di Bella, S, Di Biagio, A , Brunetti, I , Mikulska, M, Carannante, N, De Maria, A, Magnasco, L, Maraolo, AE, Mirabella, M, Montrucchio, G, Patroniti, N , Taramasso, L, Tiseo, G, Fornaro, G, Fraganza, F, Monastra, L, Roman-Pognuz, E, Paluzzano, G, Fiorentino, G, Corcione, A, Bussini, L , Pascale, R, Corcione, S, Tonetti, T , Rinaldi, M , Falcone, M, Biagioni, E, Ranieri, VM , Giannella, M , De Rosa, FG, Girardis, M, Menichetti, F, Viale, P , Pelosi, P & Bassetti, M 2021, 'Incidence and prognosis of ventilator-associated pneumonia in critically ill patients with covid-19: A multicenter study', Journal of Clinical Medicine, vol. 10, no. 4, 555, pp. 1-13. https://doi.org/10.3390/jcm10040555

Giacobbe, Daniele Roberto ; Battaglini, Denise ; Enrile, Elisa Martina ; Dentone, Chiara ; Vena, Antonio ; Robba, Chiara ; Ball, Lorenzo ; Bartoletti, Michele ; Coloretti, Irene ; Di Bella, Stefano ; Di Biagio, Antonio ; Brunetti, Iole ; Mikulska, Malgorzata ; Carannante, Novella ; De Maria, Andrea ; Magnasco, Laura ; Maraolo, Alberto Enrico ; Mirabella, Michele ; Montrucchio, Giorgia ; Patroniti, Nicolò ; Taramasso, Lucia ; Tiseo, Giusy ; Fornaro, Giacomo ; Fraganza, Fiorentino ; Monastra, Luca ; Roman-Pognuz, Erik ; Paluzzano, Giacomo ; Fiorentino, Giuseppe ; Corcione, Antonio ; Bussini, Linda ; Pascale, Renato ; Corcione, Silvia ; Tonetti, Tommaso ; Rinaldi, Matteo ; Falcone, Marco ; Biagioni, Emanuela ; Ranieri, Vito Marco ; Giannella, Maddalena ; De Rosa, Francesco Giuseppe ; Girardis, Massimo ; Menichetti, Francesco ; Viale, Pierluigi ; Pelosi, Paolo ; Bassetti, Matteo. / Incidence and prognosis of ventilator-associated pneumonia in critically ill patients with covid-19: A multicenter study. In: Journal of Clinical Medicine. 2021 ; Vol. 10, No. 4. pp. 1-13.

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abstract = "The primary objective of this multicenter, observational, retrospective study was to assess the incidence rate of ventilator-associated pneumonia (VAP) in coronavirus disease 2019 (COVID-19) patients in intensive care units (ICU). The secondary objective was to assess predictors of 30-day case-fatality of VAP. From 15 February to 15 May 2020, 586 COVID-19 patients were admitted to the participating ICU. Of them, 171 developed VAP (29%) and were included in the study. The incidence rate of VAP was of 18 events per 1000 ventilator days (95% confidence intervals [CI] 16–21). Deep respiratory cultures were available and positive in 77/171 patients (45%). The most frequent organisms were Pseudomonas aeruginosa (27/77, 35%) and Staphylococcus aureus (18/77, 23%). The 30-day case-fatality of VAP was 46% (78/171). In multivariable analysis, septic shock at VAP onset (odds ratio [OR] 3.30, 95% CI 1.43–7.61, p = 0.005) and acute respiratory distress syndrome at VAP onset (OR 13.21, 95% CI 3.05–57.26, p < 0.001) were associated with fatality. In conclusion, VAP is frequent in critically ill COVID-19 patients. The related high fatality is likely the sum of the unfavorable prognostic impacts of the underlying viral and the superimposed bacterial diseases.",

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author = "Giacobbe, {Daniele Roberto} and Denise Battaglini and Enrile, {Elisa Martina} and Chiara Dentone and Antonio Vena and Chiara Robba and Lorenzo Ball and Michele Bartoletti and Irene Coloretti and {Di Bella}, Stefano and {Di Biagio}, Antonio and Iole Brunetti and Malgorzata Mikulska and Novella Carannante and {De Maria}, Andrea and Laura Magnasco and Maraolo, {Alberto Enrico} and Michele Mirabella and Giorgia Montrucchio and Nicol{\`o} Patroniti and Lucia Taramasso and Giusy Tiseo and Giacomo Fornaro and Fiorentino Fraganza and Luca Monastra and Erik Roman-Pognuz and Giacomo Paluzzano and Giuseppe Fiorentino and Antonio Corcione and Linda Bussini and Renato Pascale and Silvia Corcione and Tommaso Tonetti and Matteo Rinaldi and Marco Falcone and Emanuela Biagioni and Ranieri, {Vito Marco} and Maddalena Giannella and {De Rosa}, {Francesco Giuseppe} and Massimo Girardis and Francesco Menichetti and Pierluigi Viale and Paolo Pelosi and Matteo Bassetti",

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AU - Dentone, Chiara

AU - Vena, Antonio

AU - Robba, Chiara

AU - Ball, Lorenzo

AU - Bartoletti, Michele

AU - Coloretti, Irene

AU - Di Bella, Stefano

AU - Di Biagio, Antonio

AU - Brunetti, Iole

AU - Mikulska, Malgorzata

AU - Carannante, Novella

AU - De Maria, Andrea

AU - Magnasco, Laura

AU - Maraolo, Alberto Enrico

AU - Mirabella, Michele

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AU - Patroniti, Nicolò

AU - Taramasso, Lucia

AU - Tiseo, Giusy

AU - Fornaro, Giacomo

AU - Fraganza, Fiorentino

AU - Monastra, Luca

AU - Roman-Pognuz, Erik

AU - Paluzzano, Giacomo

AU - Fiorentino, Giuseppe

AU - Corcione, Antonio

AU - Bussini, Linda

AU - Pascale, Renato

AU - Corcione, Silvia

AU - Tonetti, Tommaso

AU - Rinaldi, Matteo

AU - Falcone, Marco

AU - Biagioni, Emanuela

AU - Ranieri, Vito Marco

AU - Giannella, Maddalena

AU - De Rosa, Francesco Giuseppe

AU - Girardis, Massimo

AU - Menichetti, Francesco

AU - Viale, Pierluigi

AU - Pelosi, Paolo

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PY - 2021/2/2

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N2 - The primary objective of this multicenter, observational, retrospective study was to assess the incidence rate of ventilator-associated pneumonia (VAP) in coronavirus disease 2019 (COVID-19) patients in intensive care units (ICU). The secondary objective was to assess predictors of 30-day case-fatality of VAP. From 15 February to 15 May 2020, 586 COVID-19 patients were admitted to the participating ICU. Of them, 171 developed VAP (29%) and were included in the study. The incidence rate of VAP was of 18 events per 1000 ventilator days (95% confidence intervals [CI] 16–21). Deep respiratory cultures were available and positive in 77/171 patients (45%). The most frequent organisms were Pseudomonas aeruginosa (27/77, 35%) and Staphylococcus aureus (18/77, 23%). The 30-day case-fatality of VAP was 46% (78/171). In multivariable analysis, septic shock at VAP onset (odds ratio [OR] 3.30, 95% CI 1.43–7.61, p = 0.005) and acute respiratory distress syndrome at VAP onset (OR 13.21, 95% CI 3.05–57.26, p < 0.001) were associated with fatality. In conclusion, VAP is frequent in critically ill COVID-19 patients. The related high fatality is likely the sum of the unfavorable prognostic impacts of the underlying viral and the superimposed bacterial diseases.

AB - The primary objective of this multicenter, observational, retrospective study was to assess the incidence rate of ventilator-associated pneumonia (VAP) in coronavirus disease 2019 (COVID-19) patients in intensive care units (ICU). The secondary objective was to assess predictors of 30-day case-fatality of VAP. From 15 February to 15 May 2020, 586 COVID-19 patients were admitted to the participating ICU. Of them, 171 developed VAP (29%) and were included in the study. The incidence rate of VAP was of 18 events per 1000 ventilator days (95% confidence intervals [CI] 16–21). Deep respiratory cultures were available and positive in 77/171 patients (45%). The most frequent organisms were Pseudomonas aeruginosa (27/77, 35%) and Staphylococcus aureus (18/77, 23%). The 30-day case-fatality of VAP was 46% (78/171). In multivariable analysis, septic shock at VAP onset (odds ratio [OR] 3.30, 95% CI 1.43–7.61, p = 0.005) and acute respiratory distress syndrome at VAP onset (OR 13.21, 95% CI 3.05–57.26, p < 0.001) were associated with fatality. In conclusion, VAP is frequent in critically ill COVID-19 patients. The related high fatality is likely the sum of the unfavorable prognostic impacts of the underlying viral and the superimposed bacterial diseases.

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Incidence and prognosis of ventilator-associated pneumonia in critically ill patients with covid-19: A multicenter study

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